Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 61362-20 | WI |
Y | 207YS0123X | Facial Plastic Surgeon | 01073077A | IN |
NPI | 1063610301 |
---|---|
Provider Name | Dr. Babar Sultan |
First Address | Ellicott City, MD 21042-2176 |
Second Address | Indianapolis, IN 46290 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2007 |
Last Update Date | 16/07/2014 |