Individual
ROGER PATRICK SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9228 MEDICAL PLAZA DR, DEPT FAMILY MEDICINE, CHARLESTON, SC 29406-9125
(843) 876-7080
Mailing address
9228 MEDICAL PLAZA DR, DEPT FAMILY MEDICINE, CHARLESTON, SC 29406-9125
(843) 876-7080
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
LL33609
SC
Other
Enumeration date
06/07/2011
Last updated
06/07/2011
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