Individual
MARIE ELIZABETH SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-3602
(336) 716-4039
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-4039
(336) 716-6937
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
2024-00790
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/08/2020
Last updated
08/30/2024
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