Sullivan, Michael W.
Sullivan, Michael W. is an individual health care provider with primary practice located at 1600 Spearhead Division Ave Dept 140 , Fort Knox KY 40122-5104. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Sullivan, Michael W. can be contacted via phone (502) 613-4605.Contact Information
Primary practice address
1600 Spearhead Division Ave Dept 140
Fort Knox KY 40122-5104
Phone: (502) 613-4605
Fax: (502) 613-4549
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 20770 | Nebraska |
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | 37645020 | Wisconsin |
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | 30828 | Kentucky |
Profile Details
| NPI number | 1275576944 |
|---|---|
| LBN Legal business name | Sullivan, Michael W. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 13th, 2006 |
| Last updated | Jun 24th, 2014 - about 10 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 | 1275576944 | NPPES |
| Nebraska | MEDICAID | 47600743623 | |
| Nebraska | MEDICAID | 47600743612 | |
| Nebraska | MEDICAID | 47600743621 | |
| Nebraska | MEDICAID | 47600743622 |
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