Individual
THOMAS S. SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S., R.PH., BCNSP
Contact information
Practice address
21230 DEQUINDRE RD, WARREN, MI 48091-2279
(586) 880-2483
Mailing address
324 BELANGER ST, GROSSE POINTE FARMS, MI 48236-3302
(313) 378-5416
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
5302025761
MI
1835N1003X
Nutrition Support Pharmacist
Primary
5302025761
MI
Other
Enumeration date
09/09/2005
Last updated
04/07/2022
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