Sullivan, Elise D
Sullivan, Elise D is an individual health care provider with primary practice located at 785 Russell St , Craig CO 81625-2019. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Sullivan, Elise D can be contacted via phone (970) 826-2400.Contact Information
Primary practice address
785 Russell St
Craig CO 81625-2019
Phone: (970) 826-2400
Fax: (970) 826-8010
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 54286 | Colorado |
Profile Details
| NPI number | 1538365986 |
|---|---|
| LBN Legal business name | Sullivan, Elise D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 22nd, 2007 |
| Last updated | Dec 22nd, 2015 - about 10 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 | 1538365986 | NPPES |
| Colorado | MEDICAID | 34877215 |
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