Healthcare Provider Details

I. General information

NPI: 1609084664
Provider Name (Legal Business Name): SADAF SULTANA IJAZ MBBS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SADAF S IJAZ MD

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 14TH AVE SW
SIDNEY MT
59270-3519
US

IV. Provider business mailing address

213 S JEFFERSON ST STE 1006
ROANOKE VA
24011-1713
US

V. Phone/Fax

Practice location:
  • Phone: 406-488-2023
  • Fax:
Mailing address:
  • Phone: 540-224-5353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD440218
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number113418
License Number StateMT
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101270536
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberTP226
License Number StateKY
# 5
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD88752
License Number StateMD
# 6
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number195017
License Number StateNC
# 7
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number0116018182
License Number StateVA
# 8
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number43675
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: