Individual
MR. DUSTIN R SULAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
964 WESTERN AVE., MANCHESTER, ME 04351
(207) 512-8633
Mailing address
170 U.S. ROUTE 1, SUITE 200, FALMOUTH, ME 04105
(207) 482-0188
(888) 642-8601
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO2142
ME
207Q00000X
Family Medicine Physician
T0861
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
433021499
—
ME
Enumeration date
07/14/2008
Last updated
06/19/2019
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