Sullivan, John K

Sullivan, John K is an individual health care provider with primary practice located at 49 Spring St 2Nd Floor, Scarborough ME 04074-8926. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Sullivan, John K can be contacted via phone (207) 883-1414.

Contact Information

Primary practice address
49 Spring St 2Nd Floor Scarborough ME 04074-8926
Phone: (207) 883-1414
Fax: (207) 883-1518
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X MD10681 Maine

Profile Details

NPI number 1518967843
LBN Legal business name Sullivan, John K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2005
Last updated Oct 23rd, 2012 - about 12 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 1518967843 NPPES
New Hampshire MEDICAID 30004047
New Hampshire MEDICAID 290400099

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