Individual
MICHAEL A SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 OCHSNER BLVD, COVINGTON, LA 70433-8107
(985) 875-2828
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD.009718
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00012030
—
MS
05
—
1164674
—
LA
Enumeration date
06/23/2006
Last updated
08/30/2010
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