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General NPI Number Information
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NPI Number | 1437494291
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Entity Type | Organization
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Legal Business Name | SULTANA FAIYAZ CORPORATION, LLC
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Dates
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Enumeration Date | 12/05/2012
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Last Update Date | 12/05/2012
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Provider Practice Location Address
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Address Line | 4001 DUTCHMANS LN
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City | LOUISVILLE
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State | KY
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Zip | 40207-4714
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Country | US
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Telephone | 502-893-1000
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Fax | 502-412-9817
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Provider Business Mailing Address
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Address Line | PO BOX 221515
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City | LOUISVILLE
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State | KY
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Zip | 40252-1515
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Country | US
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Telephone | 937-344-9061
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Fax | 502-412-9817
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Authorized Official
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Title or Position | OWNER
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Name | MR. RASHID FAIYAZ
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Credential | M.D.
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Telephone | 937-344-9061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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