Individual
DR. SHANNON A. SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 NORTH ACADEMY AVE., DANVILLE, PA 17822-2019
(570) 214-9585
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
23319
MS
207R00000X
Internal Medicine Physician
MD461914
PA
208M00000X
Hospitalist Physician
Primary
MD461914
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/24/2012
Last updated
02/11/2021
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