Individual
JOHN G SULLIVAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11 NEVINS ST, SUITE 201, BRIGHTON, MA 02135-3514
(617) 789-2442
(617) 789-4207
Mailing address
11 NEVINS ST, SUITE 201, BRIGHTON, MA 02135-3514
(617) 789-2442
(617) 789-4207
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
35394
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2002728
—
MA
Enumeration date
09/09/2005
Last updated
07/08/2007
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