Sullivan, Pamela J

Sullivan, Pamela J is an individual health care provider with primary practice located at 1 Medical Center Drive , Clarksburg WV 26301-4199. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Sullivan, Pamela J can be contacted via phone (304) 623-3461.

Contact Information

Primary practice address
1 Medical Center Drive Clarksburg WV 26301-4199
Fax: (304) 623-7666
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 12090 West Virginia

Profile Details

NPI number 1356314306
LBN Legal business name Sullivan, Pamela J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 9th, 2006
Last updated Apr 10th, 2012 - about 14 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 1356314306 NPPES
West Virginia Other 260024338 RAILROAD MEDICARE
West Virginia MEDICAID 0116952000 RAILROAD MEDICARE

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