Individual
DAVID JAMES SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
CARILION MEMORIAL HOSPITAL, BELLVIEW AND JEFFERSON STREETS, RAONOKE, VA 24014
(540) 981-8250
Mailing address
6615 CIRCLE VIEW DR, ROANOKE, VA 24014-6601
(540) 776-2939
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
0110001586
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245281088
—
VA
Enumeration date
05/15/2006
Last updated
10/27/2008
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