MEDICARE: DR. WAMIQ SULTAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MA63364	NJ
2	207R00000X	Internal Medicine Physician	MD-056420-L	PA
3	207RN0300X	Nephrology Physician	MD-056420-L	PA
4	207RN0300X	Nephrology Physician	MA63364	NJ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
14	130018460	OTHER	NJ	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0663772000	OTHER	NJ	AMERIHEALTH HMO
2	19789	OTHER	NJ	UNIVERSITY HEALTH PLAN
3	223266219 041	OTHER	NJ	TRICARE CHAMPUS
4	1839600	OTHER	NJ	UNITED HEALTHCARE
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	SA0000055	OTHER	NJ	AMERICHOICE
7	3364422	OTHER	NJ	CIGNA HEALTHCARE
8	356685	OTHER	PA	PENNSYLVANIA BLUE SHIELD
9	356685	OTHER	PA	AMERIHEALTH PPO PABS
10	P1273820	OTHER	NJ	OXFORD HEALTH CARE
11	0595807	OTHER	NJ	AETNA US HEALTHCARE
12	1070758	OTHER	NJ	HORIZON- NJ HEALTH
13	3K6114	OTHER	NJ	HEALTHNET, INC

General Provider Information

NPI Number	:	1699873463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WAMIQ SULTAN MD

Provider Business Mailing Address
First Line	:	3241 SARUM FARM LN
Second Line	:
City	:	GARNET VALLEY
State	:	PA
Zip	:	19060-2258
Country	:	US
Telephone Number	:	856-887-3005
Fax Number	:	856-759-4035

Provider Business Practice Location Address
First Line	:	3241 SARUM FARM LN
Second Line	:
City	:	GARNET VALLEY
State	:	PA
Zip	:	19060-2258
Country	:	US
Telephone Number	:	856-887-3005
Fax Number	:	856-759-4035

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	10/17/2024

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