Provider Demographics
NPI:1548248453
Name:HAYAT, SULTAN A (MD)
Entity type:Individual
Prefix:DR
First Name:SULTAN
Middle Name:A
Last Name:HAYAT
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 1:4600 MEMORIAL DR STE W1
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62226-5359
Mailing Address - Country:US
Mailing Address - Phone:618-233-3066
Mailing Address - Fax:
Practice Address - Street 1:4600 MEMORIAL DR STE W1
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62226-5359
Practice Address - Country:US
Practice Address - Phone:618-233-3066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036065513207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
371386990OtherGREAT WEST
2276V43658OtherGHP
MO4000441OtherAETNA PPO
06065636OtherRR MEDICARE
2507046OtherUHC
IL036065513Medicaid
IL1548248456Medicaid
IL8232003OtherBCBS IL
371386990OtherHUMANA
45523OtherUHC GENCARE
98322OtherHEALTH PARTNERS
100639OtherHEALTHLINK
MO2600834OtherAETNA HMO
0973882-003OtherCIGNA
MO2808OtherBCBS MO
C42399OtherMERCY
L025925OtherTRICARE
MO4000441OtherAETNA PPO
L025925OtherTRICARE
ILL88311Medicare ID - Type Unspecified