Healthcare Provider Details

I. General information

NPI: 1396955795
Provider Name (Legal Business Name): M-IRFAN SULEMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 12/13/2024
Certification Date: 12/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3206 TOWER OAKS BLVD STE 200
ROCKVILLE MD
20852-4253
US

IV. Provider business mailing address

6224 TOWER OAKS BLVD. #200
ROCKVILLE MD
20852-5095
US

V. Phone/Fax

Practice location:
  • Phone: 240-240-9141
  • Fax:
Mailing address:
  • Phone: 502-386-2444
  • Fax: 240-240-9141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberD80521
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD80521
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberD80521
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: