Individual provider Active NPI

Sulman Mughal, MD

  • Family Medicine Physician
  • Marietta, GA
National Provider Identifier
1992481956
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
15172 Issued in GA
Practice address
1898 Clay Dr.
Marietta, GA 30064
Phone
(678) 559-4258
NPI assigned
Jun 26, 2023
Last updated
Jun 26, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 15172 GA Primary

Addresses

Primary practice location

1898 Clay Dr.
Marietta, GA 30064

Mailing address

1898 Clay Dr. SW
Marietta, GA 30064
Phone (678) 559-4258

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230717003793 GA Order and Referring Only - Family PracticePractitioner - Family Practice 3375903784

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1898 Clay Dr SW
Marietta, GA 30064-6000

PO Box
Suite 670747
Marietta, GA 30066

PO Box
Suite 670747
Marietta, GA 30066-0130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
15172GAMDFamily Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1687737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1992481956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1898 CLAY DR. SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30064",
            "telephone_number": "678-559-4258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1898 CLAY DR.",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30064",
            "telephone_number": "678-559-4258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUGHAL",
        "first_name": "SULMAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-26",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "15172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.