Physician Compare National (NPI:1467464388)

HEALTHCARE PROVIDER:

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1467464388
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2264438233
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20061013000593
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SULTAN
	Individual professional last name
Provider First Name	MAHA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1980
	Individual professional's medical school graduation year
Primary Specialty	GENERAL PRACTICE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	319 E JOSEPHINE AVE
	Group Practice or individual's line 1 address
City	FREDERICK
	Group Practice or individual's city
State	OK
	Group Practice or individual's state
Zip Code	735420177
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	370056
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	COMANCHE COUNTY MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	370153
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	ELKVIEW GENERAL HOSPTIAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	370022
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	JACKSON COUNTY MEMORIAL HOSPITAL AUTHORITY
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y