MEDICARE: JOHN G SULLIVAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	35394	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619961281
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN G SULLIVAN MD

Provider Business Mailing Address
First Line	:	11 NEVINS ST
Second Line	:	SUITE 201
City	:	BRIGHTON
State	:	MA
Zip	:	02135-3514
Country	:	US
Telephone Number	:	617-789-2442
Fax Number	:	617-789-4207

Provider Business Practice Location Address
First Line	:	11 NEVINS ST
Second Line	:	SUITE 201
City	:	BRIGHTON
State	:	MA
Zip	:	02135-3514
Country	:	US
Telephone Number	:	617-789-2442
Fax Number	:	617-789-4207

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2005
Last Update Date	:	07/08/2007

Similar Medicare Providers

1154916963 — MAKAYLA KATHLEEN POWERS
Practice Location Address:

11 NEVINS ST STE 505
BRIGHTON, MA
02135-3514

Practice Phone: 617-414-1426
Practice Fax: 617-848-3343

1326926353 — ANASTASIA MEZHERITSKAYA LICSW
Practice Location Address:

11 NEVINS ST STE 403
BRIGHTON, MA
02135-3514

Practice Phone: 617-789-3432
Practice Fax: 617-789-3052

1396742359 — PERSIS ONEEKA WILLIAMS M.D.
Practice Location Address:

11 NEVINS ST , SUITE 303
BRIGHTON, MA
02135-3514

Practice Phone: 617-787-8181
Practice Fax: 617-787-4644

1982606349 — WILLIAM J COUKOS MD
Practice Location Address:

11 NEVINS ST , SUITE 503
BRIGHTON, MA
02135-3514

Practice Phone: 617-782-1200
Practice Fax: 617-782-1521

1356336762 — RICHARD HYUNG SUNG MOON MD
Practice Location Address:

11 NEVINS ST
BRIGHTON, MA
02135-3514

Practice Phone: 617-789-2045
Practice Fax: 617-789-2932

1588659445 — BERTRAND L. JABER MD
Practice Location Address:

11 NEVINS ST STE 202
BRIGHTON, MA
02135-3514

Practice Phone: 617-779-6700
Practice Fax:

Directions to “ JOHN G SULLIVAN MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.