Sullivan, Gerald Edward

Sullivan, Gerald Edward is an sole proprietor health care provider with primary practice located at 6040 W Lisbon Ave Suite 200, Milwaukee WI 53210-2116. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Sullivan, Gerald Edward can be contacted via phone (414) 447-9890.

Contact Information

Primary practice address
6040 W Lisbon Ave Suite 200 Milwaukee WI 53210-2116
Phone: (414) 447-9890
Fax: (414) 447-9891
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 207RA0401X 37202 Wisconsin
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 37202 Wisconsin

Profile Details

NPI number 1760683551
LBN Legal business name Sullivan, Gerald Edward
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 30th, 2007
Last updated Aug 12th, 2019 - about 6 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 1760683551 NPPES
Wisconsin MEDICAID 32475500

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