Sullivan, David Wayne

Sullivan, David Wayne is an individual health care provider with primary practice located at 6029 Walnut Grove Rd Ste 301 , Memphis TN 38120-2112. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Sullivan, David Wayne can be contacted via phone (901) 747-9081.

Contact Information

Primary practice address
6029 Walnut Grove Rd Ste 301 Memphis TN 38120-2112
Phone: (901) 747-9081
Fax: (901) 747-9087
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 20920 Tennessee
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 11785 Mississippi

Profile Details

NPI number 1851399638
LBN Legal business name Sullivan, David Wayne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2005
Last updated Jun 23rd, 2021 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851399638 NPPES
Mississippi Other P00272099 RAILROAD MEDIARE
Mississippi MEDICAID 00125865 RAILROAD MEDIARE

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