Individual
TIMOTHY MICHAEL SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
920 E 28TH ST, MINNEAPOLIS, MN 55407-1139
(612) 863-6800
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
44841
MN
2085R0204X
Vascular & Interventional Radiology Physician
5847
SD
2086S0129X
Vascular Surgery Physician
Primary
44841
MN
2086S0129X
Vascular Surgery Physician
5847
SD
Other
Enumeration date
02/03/2006
Last updated
11/14/2011
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