Individual
LAWRENCE P SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
29177
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5803
INTERNAL ID-MOTOR VEHICLE ID
—
Enumeration date
10/20/2006
Last updated
04/01/2013
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