Individual
MICHAEL SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
BLDG A120, MCAS NEW RIVER, JACKSONVILLE, NC, 28445, BETHESDA, NC 28445-0001
(910) 467-3415
Mailing address
8901 ROCKVILLE PIKE, WALTER REED, BETHESDA, MD 20889
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0101262200
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/05/2015
Last updated
01/25/2024
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