DR. MUNAWAR SULTANA (NPI# 1396978979) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396978979 |
| Entity Type | Individual |
| Full Name | DR. MUNAWAR SULTANA |
| Credential | M.D |
| Practice Address |
3200 E Racine St Janesville WI 53546-2343 |
| Practice Telephone | 6083718000 |
| Practice Fax Number | 6083718938 |
| Mailing Telephone | 6083718000 |
| Mailing Fax Number | 6083718938 |
| Enumeration Date | 2009-08-28 |
| Last Update Date | 2019-07-31 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 68535-20 | WI | Allopathic & Osteopathic Physicians |
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
036130663 | IL | Ambulatory Health Care Facilities |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 125.056881 | IL | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1396978979 | 05 |
| Street Address |
3200 E RACINE ST |
| City | JANESVILLE |
| State | WI |
| Zip Code | 53546-2343 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124026208 | Mark C. Torres | Obstetrics & Gynecology | 3200 E Racine St, Janesville, WI 53546-2343 | 2005-07-12 |
| 1033719703 | Macy G Bolt | Physical Therapist | 3200 E Racine St, Janesville, WI 53546-2343 | 2020-10-30 |
| 1407489016 | Joy P. Thompson | Nurse Practitioner | 3200 E Racine St, Janesville, WI 53546-2343 | 2020-02-21 |
| 1851938419 | Hatsuho Wilkinson | Dietitian, Registered | 3200 E Racine St, Janesville, WI 53546-2343 | 2019-12-03 |
| 1013563394 | Karrie R Lynch | Nurse Practitioner | 3200 E Racine St, Janesville, WI 53546-2343 | 2019-08-13 |
| 1679128771 | Ellen Jean Ettlie | Nurse Practitioner | 3200 E Racine St, Janesville, WI 53546-2343 | 2019-08-06 |
| 1881249126 | Elizabeth F Ramer | Nurse Practitioner | 3200 E Racine St, Janesville, WI 53546-2343 | 2019-08-05 |
| 1093377905 | Nichole N Clark | Nurse Practitioner | 3200 E Racine St, Janesville, WI 53546-2343 | 2019-07-01 |
| 1386202448 | Nicole M. Wentzien | Physical Therapist | 3200 E Racine St, Janesville, WI 53546-2343 | 2019-06-04 |
| 1407322084 | Mark William Dantuma | Nurse Practitioner | 3200 E Racine St, Janesville, WI 53546-2343 | 2018-10-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366911489 | Latoya Christina Anderson | Counselor | 1818 Pershing Pl, Janesville, WI 53546 | 2018-11-19 |
| 1922599216 | Megan Arney | Speech-Language Pathologist | 9680, 4445 Woodgate Dr., Janesville, WI 53546 | 2018-05-23 |
| 1770089955 | Abby Marie Harnack | Registered Nurse | 3901 Teal Ln, Janesville, WI 53546 | 2018-04-05 |
| 1962773648 | Clark Carroll | Nurse Practitioner | 1820 Center Ave, Janesville, WI 53546 | 2012-01-26 |
| 1689983793 | Fve Mw LLC | Assisted Living Facility | 3801 North Wright Road, Janesville, WI 53546 | 2010-10-07 |
| 1831354794 | County of Rock County Clerk | Community/Behavioral Health | 3506 Hwy 51, Janesville, WI 53546 | 2008-07-21 |
| 1528225422 | Walgreen Co | Pharmacy | 2519 Kettering St, Janesville, WI 53546 | 2008-05-19 |
| 1447420351 | Michele Renee Bohland | Physical Therapy Assistant | 2540 Humes Rd, Janesville, WI 53546 | 2008-03-06 |
| 1093992158 | Emma Gene Harrell | Counselor | 203 W Sunny Lane, Janesville, WI 53546 | 2008-01-30 |
| 1457473696 | Robert Louis Fleming | Dentist | 910 Conde St, Janesville, WI 53546 | 2007-04-06 |
| Find all providers in zip 53546 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326693847 | Scenic Bluffs Health Center, Inc | Clinic/Center | 100 Blackhawk Dr, Viroqua, WI 54665-1315 | 2019-08-02 |
| 1942718762 | Sixteenth Street Community Health Centers, Inc. | Clinic/Center | 2607 S 5th St, Milwaukee, WI 53207-1418 | 2018-01-15 |
| 1659884716 | The Lakes Community Health Center, Inc | Clinic/Center | 15954 Rivers Edge Dr Ste 304, Hayward, WI 54843-7800 | 2017-11-13 |
| 1275056632 | Outreach Community Health Centers, Inc. | Clinic/Center | 9120 W Hampton Ave Ste 119, Milwaukee, WI 53225-4960 | 2017-07-18 |
| 1437695038 | Scenic Bluffs Health Center, Inc. | Clinic/Center | 200 West North Street, Norwalk, WI 54648 | 2017-01-06 |
| 1841742673 | The Lakes Community Health Center, Inc | Clinic/Center | 300 Main Street West, Ashland, WI 54806-3696 | 2016-10-27 |
| 1174071658 | Kenosha Community Health Center, Inc. | Clinic/Center | 2310 Center St, Racine, WI 53403-3330 | 2016-09-14 |
| 1841652021 | Scenic Bluffs Health Center, Inc. | Clinic/Center | 201 E Franklin St Rm B3, Sparta, WI 54656-1803 | 2016-03-25 |
| 1366844003 | Scenic Bluffs Health Center, Inc | Clinic/Center | 201 E Franklin St # B3, Sparta, WI 54656-1803 | 2014-09-25 |
| 1679983423 | The Lakes Community Health Center, Inc | Clinic/Center | 524 Bissell Street, White Lake, WI 54491 | 2014-05-02 |
| Find all providers with the same taxonomy | ||||
| City | JANESVILLE |
| Zip Code | 53546 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.