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Individual

DR. DENNIS M SULLIVAN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
CTMC, US ARMY MEDDAC, FORT DRUM, NY 13602
(315) 772-8437
Mailing address
PO BOX 159, NATURAL BRIDGE, NY 13665-0159
(315) 644-4535

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
166641
NY

Other

Enumeration date
10/25/2005
Last updated
07/08/2007
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