Individual
MR. STEVEN W SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
499 IDLEWILD AVE STE 105, EASTON, MD 21601-4049
(855) 527-7246
(866) 229-5063
Mailing address
1600 S. CRAIN HIGHWAY, SUITE 401, GLEN BURNIE, MD 21060
(410) 768-5050
(410) 768-7830
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0003015
MD
363AS0400X
Surgical Physician Assistant
Primary
C0003015
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
246492
JHHC
MD
01
—
8738246
AETNA HMO
MD
01
—
9630991
AETNA PPO
MD
Enumeration date
02/26/2008
Last updated
04/20/2026
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