Sullivan, Robert W

Sullivan, Robert W is an individual health care provider with primary practice located at 1700 Pleasure House Rd Suite 101-102, Virginia Beach VA 23455-4053. 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, Robert W can be contacted via phone (757) 363-3338.

Contact Information

Primary practice address
1700 Pleasure House Rd Suite 101-102 Virginia Beach VA 23455-4053
Phone: (757) 363-3338
Fax: (757) 363-3453
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 0103000735 Virginia

Profile Details

NPI number 1669445300
LBN Legal business name Sullivan, Robert W
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2006
Last updated Jul 24th, 2008 - about 18 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 1669445300 NPPES
Virginia Other 15443 OPTIMA
Virginia Other 412179 OPTIMA
Virginia MEDICAID 009303669 OPTIMA
Virginia Other 305079 OPTIMA
Virginia Other 480026957 OPTIMA

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