Provider Demographics
NPI:1336144682
Name:SULS, HOWARD LEE (MD)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:LEE
Last Name:SULS
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 1:20 WASHINGTON PL STE 3
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6743
Mailing Address - Country:US
Mailing Address - Phone:603-622-2112
Mailing Address - Fax:602-624-1570
Practice Address - Street 1:20 WASHINGTON PL STE 3
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6743
Practice Address - Country:US
Practice Address - Phone:603-622-2112
Practice Address - Fax:602-624-1570
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-14
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH97532083S0010X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083S0010XAllopathic & Osteopathic PhysiciansPreventive MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH5387487OtherAETNA
MAJ19289OtherBCBS OF MASS
020522402OtherALL OTHERS
NH2499524-011OtherCIGNA
NH406686OtherONE HEALTH PLAN
NH080178896OtherRAILROAD MEDICARE
NH325860OtherCIGNA
NH80004184Medicaid
NH0102955YPNH01OtherANTHEM
NH0140812OtherUNITED
NH404441OtherTUFTS
NHE75934OtherHARVARD PILGRIM
NH2427868OtherAETNA
NH2567746OtherOXFORD HEALTH
NH325860OtherCIGNA
RE4184Medicare ID - Type Unspecified