Individual
JOHN O'SULLIVAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MBBS
Contact information
Practice address
701 DELLWOOD ST S, CAMBRIDGE, MN 55008-1920
(763) 689-7700
(763) 689-7941
Mailing address
PO BOX 43, MR 10809, MINNEAPOLIS, MN 55440-0043
(612) 262-4813
(612) 262-4194
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0693
SD
208600000X
Surgery Physician
Primary
35074
MN
208600000X
Surgery Physician
3657
MT
Other
Enumeration date
03/25/2006
Last updated
07/08/2007
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