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General NPI Number Information
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NPI Number | 1518943349
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Entity Type | Individual
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Provider Name | BARBARA M SULLIVAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/22/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2829 BABCOCK RD STE 215
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City | SAN ANTONIO
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State | TX
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Zip | 78201
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Country | US
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Telephone | 210-733-4400
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Fax | 210-733-4401
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Provider Business Mailing Address
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Address Line | PO BOX 101500
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City | SAN ANTONIO
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State | TX
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Zip | 78201-9500
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Country | US
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Telephone | 210-733-4400
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Fax | 210-733-4401
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | F4576
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License Number State | TX
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