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Individual

DR. TOBY MICHAEL SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3333 SILAS CREEK PKWY, EMERGENCY DEPARTMENT, WINSTON-SALEM, NC 27103-3013
(336) 765-3928
Mailing address
PO BOX 601843, CHARLOTTE, NC 28260-1843

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2005-00836
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5900996
NC
Enumeration date
12/14/2005
Last updated
12/09/2024
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