Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | P8044 | TX |
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 40423 | SC |
NPI | 1013339290 |
---|---|
Provider Name | Dr. Fariha Batool Sultan |
First Address | Simpsonville, SC 29680-6590 |
Second Address | Greenville, SC 29615-3530 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2014 |
Last Update Date | 26/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
404235 | (05) | SC |