Individual
DR. VINCENT E. SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
19878 SAINT JOSEPH DR, CENTERVILLE, IA 52544-8850
(641) 437-1576
(641) 437-4205
Mailing address
19878 SAINT JOSEPH DR, POST OFFICE BOX 160, CENTERVILLE, IA 52544-8850
(641) 437-1576
(641) 437-4205
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
18213
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0186270
—
IA
Enumeration date
01/20/2006
Last updated
11/27/2007
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