Individual
MR. JEREMY ISAIAH SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 E MOREHEAD ST STE 100, CHARLOTTE, NC 28202-3195
(704) 342-0252
(980) 533-7801
Mailing address
801 E MOREHEAD ST STE 100, CHARLOTTE, NC 28202-3195
(704) 342-0252
(980) 533-7801
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2023-01715
NC
207RR0500X
Rheumatology Physician
Primary
2023-01715
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184151730
—
NC
01
—
20ZYO
BCBS
NC
01
—
7483509
UHC
—
01
—
7960220
CIGNA
NC
Enumeration date
05/15/2017
Last updated
01/02/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us