Individual
DR. JOHN S SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 MLK JR BLVD, 2ND FLOOR, WORCESTER, MA 01608-1209
(508) 757-1589
(508) 756-5633
Mailing address
100 MLK JR BLVD, 2ND FLOOR, WORCESTER, MA 01608-1209
(508) 757-1589
(508) 756-5633
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
57446
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0029830
NEIGHBORHOOD HEALTH PLAN
MA
01
—
0200248
UNITED HEALTH CARE
MA
01
—
042923137
TAX ID GROUP NUMBER
MA
01
—
057446
TUFTS HEALTHPLAN
MA
01
—
2376607
AETNA HEALTHCARE
MA
01
—
26920
CHILDREN'S MEDICAL SECURI
MA
01
—
326051
CIGNA HEALTHCARE
MA
05
—
6189768
—
MA
01
—
63777
FALLON HEALTH PLAN
MA
01
—
645387
HARVARD PILGRIM
MA
01
—
985163
NETWORK HEALTH
MA
01
—
J30252
BLUE CROSS BLUE SHIELD
MA
Enumeration date
06/09/2005
Last updated
09/03/2008
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