Individual
LAWRENCE X SULLIVAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4815 LIBERTY AVE, SUITE 156, PITTSBURGH, PA 15224-2156
(412) 578-3505
(412) 688-7799
Mailing address
4815 LIBERTY AVE, SUITE 156, PITTSBURGH, PA 15224-2156
(412) 578-3505
(412) 688-7799
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD041027E
PA
2086S0102X
Surgical Critical Care Physician
MD041027E
PA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD041027E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001141498
—
PA
01
—
10937285
CAQH
—
Enumeration date
12/15/2005
Last updated
10/07/2020
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