Sullivan, Jonathon

Sullivan, Jonathon is an individual health care provider with primary practice located at 4201 Saint Antoine St Suite 3R, Detroit MI 48201-2153. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medical Services, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Sullivan, Jonathon can be contacted via phone (313) 745-3000.

Contact Information

Primary practice address
4201 Saint Antoine St Suite 3R Detroit MI 48201-2153
Phone: (313) 745-3000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 4301060244 Michigan
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 4301060244 Michigan

Profile Details

NPI number 1679594394
LBN Legal business name Sullivan, Jonathon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2006
Last updated Jun 17th, 2010 - about 14 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 1679594394 NPPES
Michigan Other JS060244 BC/BS OF MICHGIAN
Michigan MEDICAID 104783832 BC/BS OF MICHGIAN
Michigan MEDICAID 103159455 BC/BS OF MICHGIAN

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