Individual
ANDREW K SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
937 HIGHLAND BLVD STE 5510, BOZEMAN, MT 59715-6916
(406) 414-4250
Mailing address
915 HIGHLAND BLVD, ATTN PFS CREDENTIALING, BOZEMAN, MT 59715-6902
(406) 414-5000
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
33493
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154412799
—
MT
Enumeration date
09/27/2006
Last updated
04/09/2025
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