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General NPI Number Information
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NPI Number | 1184683385
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Entity Type | Individual
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Provider Name | DENNIS M SULLIVAN MD
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Gender | Male
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Dates
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Enumeration Date | 03/17/2006
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Last Update Date | 05/29/2014
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Provider Practice Location Address
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Address Line | 1218 W KILBOURN AVE SUITE 301
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City | MILWAUKEE
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State | WI
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Zip | 53233-1330
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Country | US
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Telephone | 414-276-6000
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Fax | 414-276-1758
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Provider Business Mailing Address
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Address Line | 9315 N VALLEY HILL RD
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City | RIVER HILLS
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State | WI
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Zip | 53217-1036
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Country | US
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Telephone | 414-351-6392
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Fax | 414-276-1758
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 19396
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License Number State | WI
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