Individual
DR. MICHAEL ANDREW SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5115 BERNARD DR STE 201, ROANOKE, VA 24018-4367
(540) 345-0289
(540) 345-9569
Mailing address
PO BOX 13306, ROANOKE, VA 24032-3306
(540) 345-0289
(540) 345-9569
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0101238572
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689654899
—
VA
05
—
1689654899
—
WV
Enumeration date
01/23/2006
Last updated
03/05/2020
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