Sullivan, Charles W

Sullivan, Charles W is an sole proprietor health care provider with primary practice located at 98 Second St , Hallowell ME 04347-1368. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Neuromusculoskeletal Medicine & OMM. Allopathic & Osteopathic Physicians / Neuromusculoskeletal Medicine & OMM is his primary health care specialty. Sullivan, Charles W can be contacted via phone (207) 649-2795.

Contact Information

Primary practice address
98 Second St Hallowell ME 04347-1368
Phone: (207) 649-2795
Fax: (617) 488-2237
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 1048 Maine
Allopathic & Osteopathic Physicians / Neuromusculoskeletal Medicine & OMM 204D00000X 1048 Maine

Profile Details

NPI number 1003984311
LBN Legal business name Sullivan, Charles W
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 4th, 2006
Last updated Jul 19th, 2013 - about 11 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 1003984311 NPPES
Other 015555 BCBS
MEDICAID 211750000 BCBS
Other 015219 BCBS

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