Provider Demographics
NPI:1528434412
Name:SULTAN, ASSEM (MD)
Entity type:Individual
Prefix:DR
First Name:ASSEM
Middle Name:
Last Name:SULTAN
Suffix:
Gender:M
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:PO BOX 72434
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44192-0002
Mailing Address - Country:US
Mailing Address - Phone:330-668-4040
Mailing Address - Fax:
Practice Address - Street 1:437 PORTAGE TRL
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-3227
Practice Address - Country:US
Practice Address - Phone:330-929-9136
Practice Address - Fax:330-929-9189
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-14
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.140428207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine