Individual
DANIEL J SULLIVAN
Active
Individual
DANIEL J SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
0102204769
VA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
H0053418
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
325601400
—
MD
01
—
68576206
BLUE SHIELD TRADITIONAL
MD
01
—
P00297124
RR MEDICARE
—
01
—
W2660010
MD BLUE SHIELD REGIONAL
MD
Enumeration date
07/20/2006
Last updated
01/23/2026
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