Individual
DAVID MICHAEL SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
350 W COLUMBIA ST, SUITE 420, EVANSVILLE, IN 47710-1782
(812) 422-3254
(812) 426-6388
Mailing address
350 W COLUMBIA ST, SUITE 420, EVANSVILLE, IN 47710-1782
(812) 422-3254
(812) 426-6388
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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