Individual
DR. LIAM R. SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
230 MICHIGAN ST NE, SUITE 230, GRAND RAPIDS, MI 49503-2550
(616) 774-2822
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
5101017233
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619158359
—
MI
Enumeration date
11/23/2007
Last updated
03/02/2021
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