Individual
KEVIN MICHAEL SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2021 PERDIDO ST FL 8, NEW ORLEANS, LA 70112-1352
(504) 568-4750
(504) 568-2202
Mailing address
2021 PERDIDO ST FL 8, NEW ORLEANS, LA 70112-1352
(504) 568-4750
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
A171748
CA
208600000X
Surgery Physician
ML60475569
WA
2086X0206X
Surgical Oncology Physician
Primary
340298
LA
Other
Enumeration date
04/01/2014
Last updated
02/09/2024
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