Individual
DR. MONICA M O'SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11211 W LINCOLN AVE, WEST ALLIS, WI 53227-1035
(414) 454-8300
(414) 327-1450
Mailing address
11211 W LINCOLN AVE, WEST ALLIS, WI 53227-1035
(414) 454-8300
(414) 327-1450
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
44298
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004000261V
HUMANA
—
05
—
1043262546
—
WI
05
—
34193700
—
WI
Enumeration date
05/16/2006
Last updated
09/09/2021
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