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Organization
KEVIN L. SULLIVAN MD, PC
Active
Organization
KEVIN L. SULLIVAN MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN L. SULLIVAN MD (MD)
(404) 377-9171
Entity
Organization
Contact information
Practice address
250 E PONCE DE LEON AVE, DECATUR, GA 30030-3440
(404) 377-9171
(404) 977-9172
Mailing address
40 VALLEY STREAM PKWY, STE 100, MALVERN, PA 19355-1407
(610) 644-8900
(484) 924-0053
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
NULL
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
Other
Enumeration date
03/05/2008
Last updated
10/20/2016
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