Healthcare Provider Details

I. General information

NPI: 1477726115
Provider Name (Legal Business Name): IBRAHIM SULTAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2008
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BRACE RD STE H
CHERRY HILL NJ
08034-2600
US

IV. Provider business mailing address

1 BRACE RD STE H
CHERRY HILL NJ
08034-2600
US

V. Phone/Fax

Practice location:
  • Phone: 856-547-0389
  • Fax: 856-325-4293
Mailing address:
  • Phone: 856-547-0389
  • Fax: 856-325-4293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number5312
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number25IA13068800
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberMD449686
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: