Individual
DR. CHARLES M SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10100 W 119TH ST, SUITE 150, OVERLAND PARK, KS 66213-1604
(913) 754-0061
(913) 338-1311
Mailing address
PO BOX 741331, ATLANTA, GA 30374-1331
(913) 469-0503
(913) 469-5267
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0425276
KS
Other
Enumeration date
09/30/2005
Last updated
01/28/2022
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