Individual
SUSAN B SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
775 S MAIN ST, CHELSEA, MI 48118-1370
(734) 475-1311
Mailing address
2000 GREEN RD, SUITE 300, ANN ARBOR, MI 48105-1598
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
080906
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4482866
—
MI
01
—
SS080906
BLUE CROSS BLUE SHIELD
MI
Enumeration date
05/31/2006
Last updated
06/05/2008
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