Individual
BRADLEY HUSE SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6400 PROSPECT, #598, KANSAS CITY, MO 64132-4128
(816) 444-6888
(816) 444-1375
Mailing address
6400 PROSPECT AVE, #598, KANSAS CITY, MO 64132-4128
(816) 444-6888
(816) 444-1375
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
R6C60
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208258004
—
MO
Enumeration date
12/27/2005
Last updated
06/09/2010
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