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Contact Information

MACK H SULLIVAN JR, MD
44199 DEQUINDRE RD.
SUITE 518
TROY, MI48085
 Phone: 248-524-0640
 Fax: 248-994-0866
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Plastic Surgery

208200000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for MACK H SULLIVAN JR · (Male)

NPI Number 1780683151
Status Active
Credentials MD
Entity Individual
Enumeration date 07/19/2005
Last updated 01/15/2013 - About 13 years ago
Sole proprietor 1 Yes
Identifiers
  • MI License # 4301094101
Hospital affiliation(s) Not Available
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.

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