Sullivan, Brendan L

Sullivan, Brendan L is an sole proprietor health care provider with primary practice located at 9010 Lorton Station Blvd Suite 100, Lorton VA 22079-4792. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Sullivan, Brendan L can be contacted via phone (703) 436-1200.

Contact Information

Primary practice address
9010 Lorton Station Blvd Suite 100 Lorton VA 22079-4792
Phone: (703) 436-1200
Fax: (703) 642-0392
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 0101227543 Virginia

Profile Details

NPI number 1780643908
LBN Legal business name Sullivan, Brendan L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 18th, 2006
Last updated Jan 28th, 2011 - about 15 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 1780643908 NPPES
Virginia MEDICAID 6721001

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