Sullivan, Shane

Sullivan, Shane is an sole proprietor health care provider with primary practice located at 4221 Garrett Rd , Durham NC 27707-3467. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Sullivan, Shane can be contacted via phone (919) 937-9607.

Contact Information

Primary practice address
4221 Garrett Rd Durham NC 27707-3467
Phone: (919) 937-9607
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 2081S0010X P21873 North Carolina

Profile Details

NPI number 1184339699
LBN Legal business name Sullivan, Shane
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 18th, 2023
Last updated Jan 18th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184339699 NPPES
Other NA NA

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