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NPI Code Detail

MEDICARE: DR. KAREN DOROTHY SULLIVAN PH.D.

MEDICARE:  DR. KAREN DOROTHY SULLIVAN  PH.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
1103G00000XClinical Neuropsychologist4151NC

General Provider Information

NPI Number : 1871887562
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KAREN DOROTHY SULLIVAN PH.D.
Provider Business Mailing Address
First Line : 5505 OLD GREENSBORO RD
Second Line :
City : CHAPEL HILL
State : NC
Zip : 27516-4817
Country : US
Telephone Number : 919-619-1772
Fax Number : 919-966-0083
Provider Business Practice Location Address
First Line : 101 MANNING DR CB 7200
Second Line :
City : CHAPEL HILL
State : NC
Zip : 27599-4817
Country : US
Telephone Number : 919-966-9868
Fax Number : 919-966-0083
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2011
Last Update Date : 08/06/2012

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