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Individual

BRIAN P SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
101 ABBEYVILLE RD, LANCASTER, PA 17603-4603
(717) 291-5991
(717) 291-5806
Mailing address
101 ABBEYVILLE RD, LANCASTER, PA 17603-4603
(717) 291-5991
(717) 291-5806

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD423238
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1010754010001
PA
01
107749 S1QD
GEISINGER HEALTH PLAN
PA
01
1086443
AETNA HMO
PA
01
1622688
HIGHMARK BLUE SHIELD
PA
01
50036997
CAPITAL BLUE CROSS
PA
01
7996672
AETNA NON-HMO
PA
01
I07849
HEALTH ASSURANCE
PA
01
P006174
GATEWAY HEALTH PLAN
PA
Enumeration date
10/04/2005
Last updated
08/19/2007
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