Sullivan, Robert Lee

Sullivan, Robert Lee is an individual health care provider with primary practice located at 2325 Aberdeen Blvd Suite A, Gastonia NC 28054-0614. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Sullivan, Robert Lee can be contacted via phone (704) 853-3937.

Contact Information

Primary practice address
2325 Aberdeen Blvd Suite A Gastonia NC 28054-0614
Phone: (704) 853-3937
Fax: (704) 853-0840
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1401 North Carolina

Profile Details

NPI number 1023018041
LBN Legal business name Sullivan, Robert Lee
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 1st, 2005
Last updated Mar 12th, 2008 - about 17 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 1023018041 NPPES
North Carolina MEDICAID 890904M
North Carolina Other 0904M
North Carolina Other 62842
North Carolina Other 10930

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