Individual
DR. MILLER J SULLIVAN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6096 E MAIN ST STE 112, COLUMBUS, OH 43213-4302
(614) 755-3000
(614) 755-4052
Mailing address
6096 E MAIN ST STE 112, COLUMBUS, OH 43213-4302
(614) 755-3000
(614) 755-4052
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35-05-7174
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0747964
—
OH
Enumeration date
12/13/2005
Last updated
04/26/2017
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