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Individual

JULIANA B SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
101 COSGROVE AVE STE 110, CHAPEL HILL, NC 27514-5278
(919) 929-9612
(919) 929-9182
Mailing address
PO BOX 603725, CHARLOTTE, NC 28260-3725
(828) 575-2625
(828) 350-2174

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
2021-01568
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1124525506
NC
01
NNS297A
MEDICARE PTAN
NC
Enumeration date
04/11/2018
Last updated
10/30/2023
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