Individual
BRETT S SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME79310
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
49350
BCBS
FL
01
—
59169956
BCBS
AL
01
—
59169959
BCBS
AL
01
—
P00134517
PALMETTO GBA-RR MEDICARE
—
Enumeration date
06/16/2006
Last updated
07/08/2007
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