Provider Demographics
NPI:1447400460
Name:SULTANI, AMANDA V
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:V
Last Name:SULTANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 CONNECTICUT AVE NW
Mailing Address - Street 2:SUITE 1250
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-1722
Mailing Address - Country:US
Mailing Address - Phone:202-627-1901
Mailing Address - Fax:202-627-1902
Practice Address - Street 1:7187 WOODMONT AVE
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20815-6208
Practice Address - Country:US
Practice Address - Phone:240-760-1947
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-26
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPA031086363A00000X
MDT0003831363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical