Individual
DR. SHAWN E SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4838 E BASELINE RD STE 108, MESA, AZ 85206
(480) 981-2400
(480) 981-2407
Mailing address
645 E MISSOURI AVE, STE 300, PHOENIX, AZ 85012-1351
(602) 262-8900
(602) 262-8890
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
37097
AZ
207LA0401X
Addiction Medicine (Anesthesiology) Physician
37097
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
250565
—
AZ
Enumeration date
07/16/2007
Last updated
11/05/2020
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