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General NPI Number Information
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NPI Number | 1205056140
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Entity Type | Individual
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Provider Name | MICHAEL LARRY SULIT CRNA
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Gender | Male
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 1364 CLIFTON RD NE
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City | ATLANTA
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State | GA
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Zip | 30322-6600
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Country | US
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Telephone | 404-778-3900
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Fax |
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Provider Business Mailing Address
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Address Line | 3300 BEE CAVES RD STE 650-1121
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City | WEST LAKE HILLS
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State | TX
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Zip | 78746-6600
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Country | US
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Telephone | 512-417-6456
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Fax |
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 1179456
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | GAA-CRNA003141
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License Number State | GA
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