Individual
TING-YEAN W. SULLIVAN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
28 CHANDLER CTR, HARTWELL, GA 30643-7914
(706) 376-9852
(706) 376-1656
Mailing address
PO BOX 2047, ANDERSON, SC 29622-2047
(706) 376-9852
(706) 376-1656
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
45983
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00803283E
—
GA
01
—
824252
BCB-GEORGIA
—
05
—
G45983
—
SC
Enumeration date
05/30/2006
Last updated
07/08/2007
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