Individual
DR. MICHAEL DURGIN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1814 GLEN MEADE RD, WILMINGTON, NC 28403-6023
(910) 254-3544
(910) 254-3543
Mailing address
1814 GLEN MEADE RD, WILMINGTON, NC 28403-6023
(910) 254-3544
(910) 254-3543
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
200101144
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
136VC
BCBS ID
NC
01
—
200101144
MEDICAL LICENSE
NC
05
—
89136VC
—
NC
01
—
D4250
MEDCOST ID
NC
01
—
P00154798
MEDICARE RAILROAD ID
NC
Enumeration date
10/19/2006
Last updated
07/10/2025
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