Provider Demographics
NPI:1235257726
Name:SULTAN, GULSHAN A (MD)
Entity Type:Individual
Prefix:MRS
First Name:GULSHAN
Middle Name:A
Last Name:SULTAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 5808
Mailing Address - Street 2:1600 CLINGAN RIDGE DR
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37320-5808
Mailing Address - Country:US
Mailing Address - Phone:423-472-3141
Mailing Address - Fax:423-478-5160
Practice Address - Street 1:1600 CLINGAN RIDGE DR
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312
Practice Address - Country:US
Practice Address - Phone:423-472-3141
Practice Address - Fax:423-478-5160
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN-159062084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
E67984Medicare UPIN