Sullivan, C Eugene
Sullivan, C Eugene is an sole proprietor health care provider with primary practice located at 210 W Jefferson St , Boise ID 83702-6044. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Sullivan, C Eugene can be contacted via phone (208) 344-9424.Contact Information
Primary practice address
210 W Jefferson St
Boise ID 83702-6044
Phone: (208) 344-9424
Fax: (208) 343-3263
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | M3232 | Idaho |
Profile Details
| NPI number | 1649453903 |
|---|---|
| LBN Legal business name | Sullivan, C Eugene |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 10th, 2007 |
| Last updated | Dec 10th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649453903 | NPPES |
| Idaho | MEDICAID | 0024588 |
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