Organization
ROBERT D SULLIVAN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT DANIEL SULLIVAN M.D. (PRESIDENT)
(814) 944-2015
Entity
Organization
Contact information
Practice address
2323 BROAD AVE, ALTOONA, PA 16601-1937
(814) 944-2015
(814) 944-6638
Mailing address
2323 BROAD AVE, ALTOONA, PA 16601-1937
(814) 944-2015
(814) 944-6638
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
MD-032190-E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009710480002
—
PA
01
—
1017317
GATEWAY HEALTH PLAN
PA
01
—
118929
MEDICARE GROUP
PA
01
—
131605
KEYSTONE HEALTH PLAN WEST
PA
01
—
14593
HEALTHAMERICA
PA
01
—
29300
GEISINGER HEALTH PLAN
PA
01
—
306919
HEALTHASSURANCE
PA
Enumeration date
05/02/2006
Last updated
01/10/2013
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