| NPI | 1962781948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN MICHAEL SULLIVAN Physician 480-949-0298 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 3270) |
| Enumeration Date | 2011-08-09 |
| Last Update Date | 2021-03-03 |