Individual
DR. BETH ANN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1960 RIVERSIDE PKWY, STE 106, LAWRENCEVILLE, GA 30043-5945
(678) 407-2222
Mailing address
1960 RIVERSIDE PKWY, STE 106, LAWRENCEVILLE, GA 30043-5945
(678) 407-2222
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
049106
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000888698D
—
GA
05
—
10041812
—
GA
05
—
327120
—
GA
01
—
54305
SOUTHCARE ID
GA
01
—
7393382
AETNA PROVIDER ID
GA
05
—
85002412G
—
GA
01
—
903825
BCBSGA PROVIDER ID
GA
Enumeration date
06/09/2005
Last updated
03/05/2014
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us