Individual
JANET SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2412 FORUM BLVD STE 103, COLUMBIA, MO 65203-6364
(573) 445-0725
(573) 445-1027
Mailing address
2412 FORUM BLVD STE 103, COLUMBIA, MO 65203-6364
(573) 445-0725
(573) 445-1027
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2009003022
MO
Other
Enumeration date
09/27/2006
Last updated
03/11/2009
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