Sullivan, Matthew Dutton

Sullivan, Matthew Dutton is an individual health care provider with primary practice located at 87 Paine Mountain Dr Green Mountain Family Practice, Northfield VT 05663-5791. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Sullivan, Matthew Dutton can be contacted via phone (802) 485-4161.

Contact Information

Primary practice address
87 Paine Mountain Dr Green Mountain Family Practice Northfield VT 05663-5791
Phone: (802) 485-4161
Fax: (802) 485-4163
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X ML 60107751 Washington
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 042.0013288 Vermont

Profile Details

NPI number 1316273279
LBN Legal business name Sullivan, Matthew Dutton
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 28th, 2009
Last updated Oct 9th, 2015 - about 10 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 1316273279 NPPES
Washington Other ML 60107751 PHYSICIAN AND SURGEON RESIDENCY LICENSE

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