Individual
DR. MICHAEL DURGIN SULLIVAN
Active
Individual
DR. MICHAEL DURGIN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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
Update your record
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