Healthcare Provider Details

I. General information

NPI: 1558688580
Provider Name (Legal Business Name): CLAIRE EILEEN SULLIVAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2010
Last Update Date: 01/13/2021
Certification Date: 11/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 EUCLID AVENUE UNIVERSITY HOSPITALS CASE MEDICAL CENTER
CLEVELAND OH
44106
US

IV. Provider business mailing address

11100 EUCLID AVENUE UNIVERSITY HOSPITALS CASE MEDICAL CENTER
CLEVELAND OH
44106
US

V. Phone/Fax

Practice location:
  • Phone: 216-844-2562
  • Fax: 216-844-8216
Mailing address:
  • Phone: 216-844-2562
  • Fax: 216-844-8216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35-121188
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: