Individual
JAMIE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1405 S COUNTY TRL STE 510, EAST GREENWICH, RI 02818-5097
(401) 736-4570
(401) 921-6931
Mailing address
455 TOLL GATE RD, WARWICK, RI 02886-2759
(401) 737-7000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO00846
RI
390200000X
Student in an Organized Health Care Education/Training Program
LP03135
RI
Other
Enumeration date
06/06/2014
Last updated
08/02/2024
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