Provider Demographics
NPI:1770860439
Name:SULTAN, ZILLAY HUMA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ZILLAY
Middle Name:HUMA
Last Name:SULTAN
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:26901 BEAUMONT BLVD # 3D
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3849
Mailing Address - Country:US
Mailing Address - Phone:947-522-1952
Mailing Address - Fax:947-522-0307
Practice Address - Street 1:18101 OAKWOOD BLVD
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-4089
Practice Address - Country:US
Practice Address - Phone:313-593-7000
Practice Address - Fax:734-446-9750
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-09
Last Update Date:2023-06-12
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Provider Licenses
StateLicense IDTaxonomies
MI5601006214363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant