Sullivan, Mark A
Sullivan, Mark A is an individual health care provider with primary practice located at 37 Broadway Lahey Arlington, Arlington MA 02474-5552. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Sullivan, Mark A can be contacted via phone (781) 641-0100.Contact Information
Primary practice address
37 Broadway Lahey Arlington
Arlington MA 02474-5552
Phone: (781) 641-0100
Fax: (781) 744-7132
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 40783 | Massachusetts |
Profile Details
| NPI number | 1215036603 |
|---|---|
| LBN Legal business name | Sullivan, Mark A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 21st, 2006 |
| Last updated | Dec 5th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215036603 | NPPES |
| Massachusetts | MEDICAID | 2052679 |
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