Sullivan, Jerry J.
Sullivan, Jerry J. is an individual health care provider with primary practice located at 6501 Loisdale Ct , Springfield VA 22150-1826. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Sullivan, Jerry J. can be contacted via phone (703) 922-1000.Contact Information
Primary practice address
6501 Loisdale Ct
Springfield VA 22150-1826
Phone: (703) 922-1000
Fax: (703) 922-1039
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD00017070 | Washington |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 0101243402 | Virginia |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | D0071387 | Maryland |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD039385 | District of Columbia |
Profile Details
| NPI number | 1306998406 |
|---|---|
| LBN Legal business name | Sullivan, Jerry J. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 17th, 2007 |
| Last updated | Nov 22nd, 2011 - about 13 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 | 1306998406 | NPPES |
| Washington | MEDICAID | 8103087 |
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