Individual
MR. PETER J SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
927 FRANKLIN ST SE, THE ORTHOPAEDIC CENTER, HUNTSVILLE, AL 35801-4306
(256) 539-2728
(256) 428-3423
Mailing address
927 FRANKLIN ST SE, THE ORTHOPAEDIC CENTER, HUNTSVILLE, AL 35801-4306
(256) 539-2728
(256) 428-3423
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
1623
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7032826
AETNA
AL
Enumeration date
09/25/2006
Last updated
07/11/2007
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