Healthcare Provider Details

I. General information

NPI: 1457304909
Provider Name (Legal Business Name): SULTANA BEGUM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 08/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 CHEROKEE AVE SW
CULLMAN AL
35055-5502
US

IV. Provider business mailing address

1910 CHEROKEE AVE SW
CULLMAN AL
35055
US

V. Phone/Fax

Practice location:
  • Phone: 256-739-3500
  • Fax: 256-736-1093
Mailing address:
  • Phone: 256-739-3500
  • Fax: 256-775-6119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number00024528
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: