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Individual

LIAM O'SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1201 S MILLER ST, WENATCHEE, WA 98801-3201
(509) 663-8711
Mailing address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028
(509) 663-8711

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD60546517
WA
207P00000X
Emergency Medicine Physician
R73282
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1639431133
WA
01
P01520092
RR PTAN WVH
WA
01
P01520098
RR PTAN CWH
WA
Enumeration date
06/11/2012
Last updated
11/03/2015
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