Individual
DR. PATRICK SEAN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1364 CLIFTON RD NE, ATLANTA, GA 30322-0001
(404) 686-1000
Mailing address
1364 CLIFTON RD NE, ATLANTA, GA 30322-0001
(404) 686-1000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
001510
GA
208C00000X
Colon & Rectal Surgery Physician
104964
MN
208C00000X
Colon & Rectal Surgery Physician
Primary
53485
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
MN
Enumeration date
12/26/2007
Last updated
08/25/2011
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