Individual
SULTAN O. NIAZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2417 S BERKSHIRE RD, GOSHEN, IN 46526-6815
(574) 534-9911
(574) 534-6915
Mailing address
2016 S MAIN ST, GOSHEN, IN 46526-5236
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
01055340A
IN
207RP1001X
Pulmonary Disease Physician
01055340A
IN
207RS0012X
Sleep Medicine (Internal Medicine) Physician
01055340A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200400460
—
IN
01
—
P01015908
RR MEDICARE PTAN
IN
Enumeration date
01/04/2006
Last updated
04/21/2023
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