Individual
KEVIN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3150 COBB PKWY NW STE 130, KENNESAW, GA 30152-1007
(770) 966-0778
Mailing address
3664 OUTLOOK CT NE, MARIETTA, GA 30066-1788
(678) 478-0853
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
101921
GA
Other
Enumeration date
04/14/2021
Last updated
02/26/2025
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