Organization
WESTFIELD FOOT AND ANKLE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID RYAN SULLIVAN DPM (OWNER,MEMBER,PODIATRIST)
(618) 534-9193
Entity
Organization
Contact information
Practice address
16411 SOUTHPARK DR, SUITE B, WESTFIELD, IN 46074-8468
(317) 896-6655
(317) 896-6081
Mailing address
16411 SOUTHPARK DR, SUITE B, WESTFIELD, IN 46074-8468
(317) 896-6655
(317) 896-6081
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
07001049A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000574941
ANTHEM
IN
05
—
200910730
—
IN
Enumeration date
04/16/2008
Last updated
07/27/2009
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