Individual
CHARLES L SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2360 MULLAN RD, SUITE C., MISSOULA, MT 59808-1811
(406) 721-4436
(406) 721-6053
Mailing address
2360 MULLAN RD, SUITE C., MISSOULA, MT 59808-1811
(406) 721-4436
(406) 721-6053
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
12035
MT
Other
Enumeration date
05/17/2006
Last updated
06/02/2011
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