Provider Demographics
NPI:1316432024
Name:PIRELA ARAQUE, ANDRES DAVID (MD)
Entity type:Individual
Prefix:
First Name:ANDRES
Middle Name:DAVID
Last Name:PIRELA ARAQUE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7303 ROGERS AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-4112
Mailing Address - Country:US
Mailing Address - Phone:479-274-4300
Mailing Address - Fax:
Practice Address - Street 1:7303 ROGERS AVE STE 200
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-4112
Practice Address - Country:US
Practice Address - Phone:479-274-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-25
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-17124207RN0300X
FL390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program