Sullivan, Mark C
Sullivan, Mark C is an individual health care provider with primary practice located at 333 Borthwick Avenue Suite 402, Portsmouth NH 03801. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Sullivan, Mark C can be contacted via phone (603) 559-4111.Contact Information
Primary practice address
333 Borthwick Avenue Suite 402
Portsmouth NH 03801
Phone: (603) 559-4111
Fax: (603) 663-6822
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | PA 880 | Maine |
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | 0238P | New Hampshire |
Profile Details
| NPI number | 1225075328 |
|---|---|
| LBN Legal business name | Sullivan, Mark C |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 31st, 2006 |
| Last updated | Oct 4th, 2023 - about 2 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 | 1225075328 | NPPES |
| New Hampshire | MEDICAID | 3076816 |
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