Individual
MTANIUS A SULTANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
581 MEDICAL DR, CLARKSDALE, MS 38614
(662) 627-7163
(662) 627-7150
Mailing address
PO BOX 1887, CLARKSDALE, MS 38614
(662) 627-7163
(662) 627-7150
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
15212
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00117894
—
MS
05
—
135110001
—
AR
Enumeration date
02/15/2006
Last updated
05/05/2014
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