Individual
SULTAN SHAH REHMANNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15790 PAUL VEGA MD DR, HAMMOND, LA 70403-1436
(708) 629-9322
(985) 230-6480
Mailing address
15790 PAUL VEGA DR, HAMMOND, LA 70403-1436
(708) 629-9322
(985) 230-6652
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD.327925
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012489024
DRIVERS LICENSE
LA
Enumeration date
06/07/2018
Last updated
03/27/2024
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