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Individual

ELIZABETH FITZSULLIVAN

Active
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Individual

ELIZABETH FITZSULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
ML20008319
WA
2086X0206X
Surgical Oncology Physician
Primary
P3885
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
307148201
TX
Enumeration date
08/30/2006
Last updated
12/19/2012
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