Individual
DR. ROBERT SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2145 HENRY TECKLENBURG DR 220, CHARLESTON, SC 29414-2963
(843) 723-8823
(843) 606-8059
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(888) 472-0043
(843) 724-2454
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
19223
MS
207L00000X
Anesthesiology Physician
2008-01579
NC
207L00000X
Anesthesiology Physician
32237
SC
207LP2900X
Pain Medicine (Anesthesiology) Physician
2008-01579
NC
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
32237
SC
208VP0014X
Interventional Pain Medicine Physician
2008-01579
NC
208VP0014X
Interventional Pain Medicine Physician
32237
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
152J3
BCBSNC
NC
05
—
5911895
—
NC
05
—
NC1040
—
SC
01
—
P01011085
RAILROAD-MEDICARE
NC
01
—
P01163110
RAILROAD-MEDICARE
SC
Enumeration date
07/16/2007
Last updated
05/23/2024
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