Individual
DR. CRAIG D SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
63 CRESCENT AVE, GREEN MOUNTAIN FAMILY PRACTICE, NORTHFIELD, VT 05663-5704
(802) 485-4161
(802) 485-4163
Mailing address
PO BOX 547, CENTRAL VERMONT MEDICAL CENTER - FINANCE DEPT, BARRE, VT 05641-0547
(802) 485-4161
(802) 485-4163
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
042-0007006
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005680
—
VT
Enumeration date
12/16/2005
Last updated
12/04/2014
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