Individual
BRETT S SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 W MORENO ST, PENSACOLA, FL 32501-2316
(850) 437-8390
(850) 437-8394
Mailing address
PO BOX 10824, BIRMINGHAM, AL 35202-0824
(205) 322-1808
(205) 322-1851
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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