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NPI Code Detail

MEDICARE: MEGAN M SULLIVAN M.D.

MEDICARE: MEGAN M SULLIVAN M.D.
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
1207RR0500XRheumatology Physician58832AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1841726759
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN M SULLIVAN M.D.
Provider Business Mailing Address
First Line : PO BOX 860912
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55486-0912
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 13400 E SHEA BLVD
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85259-5452
Country : US
Telephone Number : 480-301-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2017
Last Update Date : 12/03/2025

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