Mark Robert Sullivan in Shelby Township - General Practice
Mark Robert Sullivan - NPI 1407056112
Mark Robert Sullivan is a General Practice in Shelby Township, Michigan. Mark Robert Sullivan practices all healthcare services and medical treatments related to General Practice. The NPI Number for Mark Robert Sullivan is 1407056112. The last update date is 2016-05-25.
Mark Robert Sullivan's current location address is 55191 Shelby Rd, Shelby Township, Michigan. You can contact this provider via phone number 5867979118 and fax number 5867979085. The mailing address for Mark Robert Sullivan is 55191 Shelby Rd, Shelby Township, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mark Robert Sullivan |
|---|---|
| Address | 55191 Shelby Rd, Shelby Township, Michigan |
| Phone Number | 5867979118 |
| Fax Number | 5867979085 |
| Sole Proprietor | Y |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1407056112 |
|---|---|
| Provider Enumeration Date | 2007-07-20 |
| Last Updated Date | 2016-05-25 |
Provider Mailing Address Detail
| Address | 55191 Shelby Rd |
|---|---|
| City | Shelby Township |
| State | Michigan (MI) |
| Post Code | 483161150 |
| Phone Number | 5867979118 |
| Fax Number | 5867979085 |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 1223G0001X |
| Licence No | 12343 |
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Definition: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 4062594 | MI | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Mark Robert Sullivan by the Centers for Medicare & Medicaid Services (CMS)?
The Mark Robert Sullivan has been assigned the NPI (National Provider Identifier) 1407056112. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please share the complete physical location address where Mark Robert Sullivan's facilities are situated?
The facilities of Mark Robert Sullivan are physically located at the following address: 55191 Shelby Rd, Shelby Township, MI, 483161150.
What is the Mark Robert Sullivan's specialty and taxonomy code?
The Mark Robert Sullivan's specialty is General Practice, and the corresponding taxonomy code is 1223G0001X.
On what date did the Centers for Medicare & Medicaid Services assign the 1407056112 to Mark Robert Sullivan?
The Centers for Medicare & Medicaid Services assigned the 1407056112 to Mark Robert Sullivan on 2007-07-20.
When was the Mark Robert Sullivan's information last updated?
The Mark Robert Sullivan's information was last updated on 2016-05-25.
NPI Number: 1215930573
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