Individual
MARTIN J SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
50 HOSPITAL DR, SUITE 3B2, HENDERSONVILLE, NC 28792-5248
(828) 687-0088
(828) 684-6693
Mailing address
PO BOX 1869, FLETCHER, NC 28732-1869
(828) 687-5616
(828) 650-8076
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
2003000087
MO
207RC0000X
Cardiovascular Disease Physician
Primary
29044
NC
207RC0000X
Cardiovascular Disease Physician
45065
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10001627200
COMMUNITY HEALTH PLAN
MO
05
—
1514006
—
TN
05
—
203715016
—
MO
01
—
4230692
BCBST
TN
Enumeration date
09/01/2006
Last updated
04/01/2021
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