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General NPI Number Information
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NPI Number | 1154582146
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Entity Type | Individual
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Provider Name | ELIZABETH HOWE SULLIVAN MD
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Gender | Female
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Dates
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Enumeration Date | 06/23/2008
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 144 US ROUTE 1 STE 2
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City | SCARBOROUGH
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State | ME
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Zip | 04074-7219
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Country | US
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Telephone | 207-396-7606
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Fax | 207-819-6802
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Provider Business Mailing Address
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Address Line | 144 US ROUTE 1 STE 2
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City | SCARBOROUGH
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State | ME
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Zip | 04074-7219
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Country | US
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Telephone | 207-396-7606
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Fax | 207-819-6802
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 268551
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD20834
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License Number State | ME
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 77166-20
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | 77166-20
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License Number State | WI
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