Individual
DANIEL J SULLIVAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1233 E 2ND ST, CASPER, WY 82601-2926
(307) 577-2198
(307) 687-7243
Mailing address
P.O. DRAWER 50460, CASPER, WY 82605
(307) 577-0136
(307) 687-7243
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
2624A
WY
Other
Enumeration date
07/19/2005
Last updated
07/08/2007
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