Sullivan, Marion Louise

Sullivan, Marion Louise is an individual health care provider with primary practice located at 2000 W Bethany Home Rd , Phoenix AZ 85015-2443. She recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as her primary health care specialty. Sullivan, Marion Louise can be contacted via phone (602) 299-0212.

Contact Information

Primary practice address
2000 W Bethany Home Rd Phoenix AZ 85015-2443
Phone: (602) 299-0212
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 17124 Arizona

Profile Details

NPI number 1962493692
LBN Legal business name Sullivan, Marion Louise
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2005
Last updated Nov 13th, 2007 - about 19 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 1962493692 NPPES
Arizona Other AZ0728670 BCBS GROUP
Arizona Other 4153051001 BCBS GROUP
Arizona Other 39-87220 BCBS GROUP
Arizona MEDICAID 411009 BCBS GROUP
Arizona Other AW1936 BCBS GROUP

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