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Individual

DR. BRIAN P SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
135 WEBSTER ST, HANOVER, MA 02339-1200
(781) 878-7020
(781) 871-3590
Mailing address
4 EVERGREEN ST, HINGHAM, MA 02043-1014

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
74990
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1025541
AETNA
01
13867
HPHC
MA
01
139146
CIGNA
05
3183238
MA
01
74990
TUFTS
01
J12638
BCBS
MA
Enumeration date
12/07/2005
Last updated
04/24/2009
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