Individual
PATRICK B. SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
164 SUMMIT AVE, PROVIDENCE, RI 02906-2894
(401) 793-3000
Mailing address
125 WHIPPLE ST STE 3, PROVIDENCE, RI 02908-3258
(401) 854-2504
(401) 427-7795
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
282126
MA
207P00000X
Emergency Medicine Physician
MD14523
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110099845A
—
MA
Enumeration date
06/03/2010
Last updated
10/30/2023
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