Individual
DR. TIMOTHY MICHAEL SULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1309
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09885
BLUE CROSS BLUE SHIELD
NC
01
—
2256770
UNITED HEALTH CARE
NC
05
—
8909885
—
NC
Enumeration date
04/23/2007
Last updated
09/12/2007
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