Individual
MARK F SULLIVAN SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11236 ROBINWOOD DR, # 7, HAGERSTOWN, MD 21742-6708
(301) 665-4760
(301) 665-4761
Mailing address
322 E ANTIETAM ST, STE 106, HAGERSTOWN, MD 21740-5736
(301) 739-6147
(301) 739-6163
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD038772E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017873640003
—
PA
01
—
11528138
AETNA
PA
01
—
348403
HIGHMARK
PA
Enumeration date
03/07/2006
Last updated
10/18/2020
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