Provider Type Icon

SULLIVAN MEDICAL CLINIC LLC NPI 1205263159


NPI Information

NPI: 1205263159
Provider Name: SULLIVAN MEDICAL CLINIC, LLC
Classification: Internal Medicine - 207RA0401X
Entity Type: Organization

Specialization: Addiction Medicine

Address:
6040 W LISBON AVE
SUITE 200
MILWAUKEE, WI
ZIP 53210
Phone: (414) 447-9890
Get Directions

SULLIVAN MEDICAL CLINIC, LLC is an addiction medicine internal medicine in Milwaukee, WI. The provider is an internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. SULLIVAN MEDICAL CLINIC, LLC NPI is 1205263159. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6040 W LISBON AVE
SUITE 200
MILWAUKEE, WI
ZIP 53210-116
Phone: (414) 447-9890
Fax: (414) 447-9891

The provider's authorized official is Gerald E Sullivan .
The authorized official title is Sole Mbr and has the following contact phone number (414) 447-9890.

The enumeration date for this NPI number is 10/7/2013 and was last updated on 10/7/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RA0401XInternal MedicineAddiction MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.