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Individual

EUGENE DENIS SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
5701 BOW POINTE DR, SUITE 100, CLARKSTON, MI 48346-3198
(248) 625-2621
(248) 625-8938
Mailing address
5701 BOW POINTE DR, SUITE 100, CLARKSTON, MI 48346-3198
(248) 625-2621
(248) 625-8938

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601003867
MI

Other

Enumeration date
03/09/2006
Last updated
03/29/2010
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