Provider Demographics
NPI:1093909137
Name:SULTANA, AYESHA (MD)
Entity Type:Individual
Prefix:DR
First Name:AYESHA
Middle Name:
Last Name:SULTANA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5509 SOUTHERN CROSS AVE
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-4015
Mailing Address - Country:US
Mailing Address - Phone:919-337-7350
Mailing Address - Fax:
Practice Address - Street 1:1001 W WILLIAMS ST
Practice Address - Street 2:SUITE 102, APEX MEDICAL PARK
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-3978
Practice Address - Country:US
Practice Address - Phone:919-300-7726
Practice Address - Fax:919-300-7688
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-31
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2008-01657208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics