Provider Demographics
NPI:1114975471
Name:LAKHANI, SULTAN A (MD)
Entity Type:Individual
Prefix:
First Name:SULTAN
Middle Name:A
Last Name:LAKHANI
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 1:1510 N 28TH ST
Mailing Address - Street 2:MOB, SUITE 101
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-5311
Mailing Address - Country:US
Mailing Address - Phone:804-371-1670
Mailing Address - Fax:804-371-1671
Practice Address - Street 1:1510 N 28TH ST
Practice Address - Street 2:MOB, SUITE 101
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-5311
Practice Address - Country:US
Practice Address - Phone:804-371-1670
Practice Address - Fax:804-371-1671
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010510952084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007111207Medicaid
VAC06115OtherGROUP PTAN
VA260002850OtherDAILY PLANET MEDICARE NUM
VA260002850OtherDAILY PLANET MEDICARE NUM
VA007111207Medicaid