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Organization
LONGEVITY MEDICAL CENTER, PC
Active
Organization
LONGEVITY MEDICAL CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAIRA SULTAN (DOO)
(770) 676-6000
Entity
Organization
Contact information
Practice address
4646 N SHALLOWFORD RD STE 300, ATLANTA, GA 30338-6308
(678) 736-6383
(678) 280-6761
Mailing address
1551 DUNWOODY VILLAGE PKWY UNIT 888426, ATLANTA, GA 30356-0115
(678) 736-6383
(678) 280-6761
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
11/08/2018
Last updated
11/08/2018
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