# PETER J SULLIVAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1306292024
- **Gender:** Man
- **Credential:** DO

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | 9408895 | KS | — |
| 208800000X | Urology Physician | 05-43714 | KS | Yes |
| 208800000X | Urology Physician | 2026016769 | MO | — |
| 390200000X | Student in an Organized Health Care Education/Training Program | — | — | — |

## Other

- **Enumeration date:** 05/12/2016
- **Last updated:** 06/30/2026