Organization
SULLIVAN PEDIATRICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JANET SULLIVAN M.D. (MEDICAL DIRECTOR)
(573) 999-1657
Entity
Organization
Contact information
Practice address
2614 FORUM BLVD, COLUMBIA, MO 65203-5431
(573) 999-1657
(650) 560-1839
Mailing address
2614 FORUM BLVD, COLUMBIA, MO 65203-5431
(573) 999-1657
(650) 560-1839
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2009003022
MO
Other
Enumeration date
12/14/2010
Last updated
12/14/2010
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