| NPI | 1235769456 |
|---|---|
| Doing Business As | SULLIVAN MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | AJAY DESHPANDE Managing Partner 812-605-0543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2020-01-16 |
| Last Update Date | 2020-01-16 |