Individual
DAVID MICHAEL SULLIVAN
Active
Individual
DAVID MICHAEL SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01046583A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200127300
—
IN
01
—
300075778
RAILROAD MEDICARE
IN
01
—
300095207
RAILROAD MEDICARE
IN
05
—
64880438
—
KY
01
—
P00356434
RAILROAD MEDICARE
IN
Enumeration date
10/04/2005
Last updated
08/07/2025
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