Individual
DR. MAIA ELISE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
5900 BYRON CENTER AVE SW, WYOMING, MI 49519-9686
(616) 252-7604
(616) 252-0391
Mailing address
5900 BYRON CENTER AVE SW, WYOMING, MI 49519-9686
(616) 252-7604
(616) 252-0391
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
51010224168
MI
Other
Enumeration date
06/26/2018
Last updated
03/19/2020
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