Provider Demographics
NPI:1225293046
Name:SULTAN, ALSADEK (MD)
Entity Type:Individual
Prefix:
First Name:ALSADEK
Middle Name:
Last Name:SULTAN
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 1:8954 HOSPITAL DRIVE
Mailing Address - Street 2:DOUGLAS HOSPITALIST
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30314
Mailing Address - Country:US
Mailing Address - Phone:678-838-2585
Mailing Address - Fax:
Practice Address - Street 1:8954 HOSPITAL DRIVE
Practice Address - Street 2:DOUGLAS HOSPITALIST
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30314
Practice Address - Country:US
Practice Address - Phone:678-838-2585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-21
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA066087208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist