Sullivan, Craig D

Sullivan, Craig D is an individual health care provider with primary practice located at 63 Crescent Ave Green Mountain Family Practice, Northfield VT 05663-5704. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Sullivan, Craig D can be contacted via phone (802) 485-4161.

Contact Information

Primary practice address
63 Crescent Ave Green Mountain Family Practice Northfield VT 05663-5704
Phone: (802) 485-4161
Fax: (802) 485-4163
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 042-0007006 Vermont

Profile Details

NPI number 1194701615
LBN Legal business name Sullivan, Craig D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 16th, 2005
Last updated Dec 4th, 2014 - 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 1194701615 NPPES
Vermont MEDICAID 0005680

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