Individual
BRADLEY SULTAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9315 MORNING WALK DR, HAGERSTOWN, MD 21740-1485
(443) 639-5907
Mailing address
9315 MORNING WALK DR, HAGERSTOWN, MD 21740-1485
(443) 639-5907
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46-1389078
EYEWEAR
—
Enumeration date
06/07/2019
Last updated
06/11/2019
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