Individual
PETER DAMIAN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD # BTE119, PORTLAND, OR 97239-3011
(503) 494-6101
Mailing address
3181 SW SAM JACKSON PARK RD # BTE119, PORTLAND, OR 97239-3011
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
MD19673
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
151214
—
OR
Enumeration date
09/20/2006
Last updated
07/11/2007
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