National Provider Identifier Database

MICHAEL P SULLIVAN, MD – NPI #1336105626
Neurology

A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.


Contact Information

MICHAEL P SULLIVAN, MD
2101 SOUTH AVE
SOUTH LAKE TAHOE, CA96150
Phone: 530-542-5744
Fax: 530-542-5747
Website:
Specialty Taxonomy Code
* Neurology 2084N0400X

* Indicates primary specialty

NPI Profile & details for MICHAEL P SULLIVAN

NPI Number 1336105626
Credentials MD
Entity Individual
Enumeration date 04/25/2006
Last updated 09/28/2012 - About 14 years ago
Sole proprietor1 Yes
Identifiers
  • CA License #: G40941
  • NV License #: 6833
  • CA Medicaid: 00G409410
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for MICHAEL P SULLIVAN, MD

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