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Individual

MICHAEL JOHN SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
73-5600 MAIAU ST, KAILUA KONA, HI 96740-2630
(808) 331-4808
(808) 331-4861
Mailing address
73-5600 MAIAU ST, KAILUA KONA, HI 96740-2630
(808) 331-4808
(808) 331-4861

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
05637
NV
183500000X
Pharmacist
27185
CA
183500000X
Pharmacist
5929
MT
183500000X
Pharmacist
Primary
PH1786
HI

Other

Enumeration date
03/13/2012
Last updated
03/13/2012
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