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Individual

DR. BRIAN J SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1000 BESTGATE RD STE 400, ANNAPOLIS, MD 21401
(410) 266-2720
(410) 244-0209
Mailing address
1000 BESTGATE RD STE 400, ANNAPOLIS, MD 21401-3371
(410) 266-2720
(410) 224-0209

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
D0050954
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
352303900
MD
01
3550284
AETNA
01
471782
MAMSI
01
487760200
FEDERAL WORKMANS COMP
01
76918803
BCBS
01
76918804
BCBS
01
76918806
BCBS
MD
01
76918807
BCBS
MD
01
D3800006
BCBS
DC
01
J4570002
BCBS
DC
01
W8490002
BCBS
DC
Enumeration date
07/14/2005
Last updated
11/26/2018
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