Sullivan, Michael

Sullivan, Michael is an individual health care provider with primary practice located at 1700 1St Ave Ne Suite 210, Cedar Rapids IA 52402-5433. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Sullivan, Michael can be contacted via phone (319) 363-3543.

Contact Information

Primary practice address
1700 1St Ave Ne Suite 210 Cedar Rapids IA 52402-5433
Phone: (319) 363-3543
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 00832 Iowa
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 2003000653 Missouri

Profile Details

NPI number 1134290646
LBN Legal business name Sullivan, Michael
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 13th, 2006
Last updated Jul 27th, 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 1134290646 NPPES
Missouri MEDICAID 308753201

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