Individual
THOMAS DENNIS SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3795 MANSELL RD, ALPHARETTA, GA 30022-8247
(404) 785-8540
(404) 785-8574
Mailing address
5318 TROWBRIDGE DR, ATLANTA, GA 30338-3623
(770) 671-8349
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
15512
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000971132
—
GA
Enumeration date
05/25/2006
Last updated
12/10/2013
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