Individual
DR. SULTAN AHAMED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
29 GRAVEL ST, MYSTIC, CT 06355-1837
(860) 608-5810
(860) 572-3920
Mailing address
29 GRAVEL ST, MYSTIC, CT 06355-1837
(860) 608-5810
(860) 572-3920
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
015920
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010015920CT04
ANTHEM BC BS OF CT
CT
01
—
2V2557
HEALTHNET
CT
01
—
D418684
OXFORD HEALTH PLANS
CT
Enumeration date
08/27/2006
Last updated
07/08/2007
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