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NPI Code Detail

MEDICARE: SULLIVAN PLASTIC AND RECONSTRUCTIVE SURGEY CENTER, INC

MEDICARE: SULLIVAN PLASTIC AND RECONSTRUCTIVE SURGEY CENTER, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QA1903XAmbulatory Surgical Clinic/Center216 / ID 0317ASOH

General Provider Information

NPI Number : 1669468278
Entity Type Code : Organization
Provider Name (Legal Business Name) : SULLIVAN PLASTIC AND RECONSTRUCTIVE SURGEY CENTER, INC
Provider Business Mailing Address
First Line : 7706 OLENTANGY RIVER RD
Second Line :
City : COLUMBUS
State : OH
Zip : 43235-1317
Country : US
Telephone Number : 614-436-8888
Fax Number : 614-436-8847
Provider Business Practice Location Address
First Line : 7706 OLENTANGY RIVER RD
Second Line :
City : COLUMBUS
State : OH
Zip : 43235-1317
Country : US
Telephone Number : 614-436-8888
Fax Number : 614-436-8847
Authorized Official
Title or Position : PRESIDENT
Name : MICHAEL SULLIVAN
Credential : M.D.
Telephone Number : 614-436-8888
Provider Enumeration Date : 09/20/2005
Last Update Date : 08/22/2020

Similar Medicare Providers

1437145646 — MICHAEL J SULLIVAN
Practice Location Address:
7706 OLENTANGY RIVER RD
COLUMBUS, OH
43235-1317
Practice Phone: 614-436-8888
Practice Fax: 614-436-8847
1598751752 — CHRISTINE M SULLIVAN M.D.
Practice Location Address:
7706 OLENTANGY RIVER RD
COLUMBUS, OH
43235-1317
Practice Phone: 614-436-8888
Practice Fax: 614-436-8847
1285922179 — STEPHEN JACOB NOGAN M.D.
Practice Location Address:
7706 OLENTANGY RIVER RD
COLUMBUS, OH
43235-1317
Practice Phone: 614-366-8175
Practice Fax:
1386257046 — DARYL JEAN HINES PA-C
Practice Location Address:
7706 OLENTANGY RIVER RD
COLUMBUS, OH
43235-1317
Practice Phone: 614-436-8888
Practice Fax: 614-413-3094
1326705336 — SHIREEN SHATTI APRN-CNP
Practice Location Address:
7706 OLENTANGY RIVER RD
COLUMBUS, OH
43235-1317
Practice Phone: 614-366-8175
Practice Fax:
1851135594 — STEPHEN NOGAN
Practice Location Address:
7706 OLENTANGY RIVER RD
COLUMBUS, OH
43235-1317
Practice Phone: 614-436-8888
Practice Fax:

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