Individual
DR. CHRISTOPHER SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
169 ASHLEY AVENUE, ROOM 202 MAIN HOSPITAL, MSC 333, CHARLESTON, SC 29425
(843) 792-1086
Mailing address
169 ASHLEY AVENUE, ROOM 202 MAIN HOSPITAL, MSC 333, CHARLESTON, SC 29425
(843) 792-1086
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
LL82528
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LL82528
SOUTH CAROLINA BOARD OF MEDICAL EXAMINERS
SC
Enumeration date
06/06/2019
Last updated
06/06/2019
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