Basic Information
| Provider Information | |||||||||
| NPI: | 1962768895 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BABAR | ||||||||
| FirstName: | SULTAN | ||||||||
| MiddleName: | MAHMOOD | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 701 DOCTORS DR | ||||||||
| Address2: | SUITE G | ||||||||
| City: | KINSTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285011589 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2525224446 | ||||||||
| FaxNumber: | 2525224484 | ||||||||
| Practice Location | |||||||||
| Address1: | 701 DOCTORS DR | ||||||||
| Address2: | SUITE G | ||||||||
| City: | KINSTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285011589 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2525224446 | ||||||||
| FaxNumber: | 2525224484 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/04/2012 | ||||||||
| LastUpdateDate: | 02/05/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/05/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QS0010X | 2016-01233 | NC | Y | Allopathic & Osteopathic Physicians | Family Medicine | Sports Medicine |
No ID Information.