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General NPI Number Information
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NPI Number | 1659631018
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Entity Type | Individual
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Provider Name | PATRICK SEAN SULLIVAN DVM
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Gender | Male
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Dates
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Enumeration Date | 05/20/2012
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Last Update Date | 05/20/2012
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Provider Practice Location Address
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Address Line | 1628 RAINIER FALLS DR NE
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City | ATLANTA
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State | GA
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Zip | 30329-4108
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Country | US
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Telephone | 404-210-6039
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Fax | 866-311-8234
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Provider Business Mailing Address
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Address Line | 1628 RAINIER FALLS DR NE
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City | ATLANTA
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State | GA
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Zip | 30329-4108
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Country | US
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Telephone | 404-210-6039
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Fax | 866-311-8234
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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 | 174M00000X
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Taxonomy Name | Veterinarian
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License Number | VET005024
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License Number State | GA
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