Individual
DR. MARY P SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1815 HAND AVE, BAY MINETTE, AL 36507-4110
(251) 580-1717
Mailing address
1815 HAND AVE, BAY MINETTE, AL 36507-4110
(251) 937-5521
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
DO832
AL
207P00000X
Emergency Medicine Physician
DO832
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051000772
BLUE CROSS&BLUE SHIELD
AL
Enumeration date
08/11/2006
Last updated
10/16/2024
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