Individual
MR. MACK HUGH SULLIVAN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
44199 DEQUINDRE RD., SUITE 518, TROY, MI 48085
(248) 524-0640
(248) 994-0866
Mailing address
44199 DEQUINDRE RD., SUITE 518, TROY, MI 48085
(248) 524-0640
(248) 994-0866
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
4301094101
MI
Other
Enumeration date
07/19/2005
Last updated
01/15/2013
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