Provider Demographics
NPI:1154899979
Name:ALQAHTANI, ASHWAG SULTAN (MD)
Entity type:Individual
Prefix:
First Name:ASHWAG
Middle Name:SULTAN
Last Name:ALQAHTANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 RIVERSIDE STATION BLVD APT 313
Mailing Address - Street 2:
Mailing Address - City:SECAUCUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07094-4437
Mailing Address - Country:US
Mailing Address - Phone:908-463-7477
Mailing Address - Fax:
Practice Address - Street 1:200 RIVERSIDE STATION BLVD APT 313
Practice Address - Street 2:
Practice Address - City:SECAUCUS
Practice Address - State:NJ
Practice Address - Zip Code:07094-4437
Practice Address - Country:US
Practice Address - Phone:908-463-7477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-09
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program