Individual
DR. BRIAN J SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1250 SW VETERANS WAY STE 120, REDMOND, OR 97756
(541) 923-4462
Mailing address
600 SW COLUMBIA ST STE 6210, BEND, OR 97702-1099
(541) 383-3005
(541) 383-1883
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
257372
MA
207Q00000X
Family Medicine Physician
Primary
MD186677
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500740526
—
OR
Enumeration date
03/27/2009
Last updated
01/30/2023
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