Individual
DR. MARION LOUISE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2000 W BETHANY HOME RD, PHOENIX, AZ 85015-2443
(602) 299-0212
Mailing address
9842 N 52ND ST, PARADISE VALLEY, AZ 85253-1018
(480) 348-1678
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
17124
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39-87220
EVERCARE GROUP
AZ
05
—
411009
—
AZ
01
—
4153051001
GROUP HEALTH GROUP NUMBER
AZ
01
—
AW1936
HEALTHNET GROUP
AZ
01
—
AZ0728670
BCBS GROUP
AZ
Enumeration date
11/02/2005
Last updated
11/13/2007
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