Individual
LAWRENCE LOWREY SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12 CREST RD, ST ALBANS, VT 05478
(802) 524-3215
(802) 524-5523
Mailing address
12 CREST RD, SAINT ALBANS, VT 05478
(802) 524-3215
(802) 524-5523
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
0420009902
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0VN2247
—
VT
Enumeration date
07/06/2006
Last updated
10/30/2013
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