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Individual

DR. ELIXABETH LASKURAIN SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3930 WALNUT ST STE 101, FAIRFAX, VA 22030-4750
(703) 246-9246
(703) 246-9257
Mailing address
3930 WALNUT ST STE 101, FAIRFAX, VA 22030-4750
(703) 246-9246

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101268835
VA
207RN0300X
Nephrology Physician
Primary
0101268835
VA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/15/2015
Last updated
05/29/2024
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