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Individual

MICHAEL P SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1000 N OAK AVE, MARSHFIELD, WI 54449
(715) 387-5690
Mailing address
1000 N OAK AVE, MARSHFIELD, WI 54449-5777
(715) 387-5690

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
48557
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
34812300
WI
Enumeration date
08/31/2006
Last updated
06/14/2024
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