Sullivan, Robert D
Sullivan, Robert D is an sole proprietor health care provider with primary practice located at 1195 N Casaloma Dr , Appleton WI 54913-9295. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Sullivan, Robert D can be contacted via phone (920) 734-0400.Contact Information
Primary practice address
1195 N Casaloma Dr
Appleton WI 54913-9295
Phone: (920) 734-0400
Fax: (920) 734-9054
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 18799 | Wisconsin |
Profile Details
| NPI number | 1447347190 |
|---|---|
| LBN Legal business name | Sullivan, Robert D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 6th, 2006 |
| Last updated | Feb 19th, 2008 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1447347190 | NPPES |
| Wisconsin | MEDICAID | 30125300 |
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