Organization
JAMES J SULLIVAN DO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES J SULLIVAN DO (OWNER)
(517) 426-4521
Entity
Organization
Contact information
Practice address
105 W 5TH ST, GLADWIN, MI 48624-1162
(517) 426-4521
Mailing address
3061 CHRISTY WAY, SAGINAW, MI 48603-2267
(989) 791-2455
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101004290
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1039903
—
MI
Enumeration date
07/03/2006
Last updated
09/24/2009
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