Individual
DR. SHANNON DANIELLE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3800 RESERVOIR RD NW, WASHINGTON, DC 20007-2113
(202) 444-2600
(202) 444-4859
Mailing address
1526 17TH ST NW, #402, WASHINGTON, DC 20036-6216
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101242009
VA
390200000X
Student in an Organized Health Care Education/Training Program
0101242009
VA
Other
Enumeration date
06/02/2008
Last updated
02/08/2013
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