Daniel L Sullivan, MD | |
600 East Blvd, Elkhart, IN 46514-2483 | |
(574) 523-3160 | |
Not Available |
Full Name | Daniel L Sullivan |
---|---|
Gender | Male |
Speciality | Emergency Medicine - Emergency Medical Services |
Location | 600 East Blvd, Elkhart, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1386612224 | NPI | - | NPPES |
100259050 | Medicaid | IN | |
102668920 | Medicaid | MI | |
000000082211 | Other | IN | ANTHEM |
010029958 | Other | IN | RAIL ROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207PE0004X | Emergency Medicine - Emergency Medical Services | 100259050 (Indiana) | Primary |
Entity Name | Elite Emergency Physicians Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1932155371 PECOS PAC ID: 8022087642 Enrollment ID: O20040930000456 |
Mailing Address | Practice Location Address |
---|---|
Daniel L Sullivan, MD Po Box 1241, South Bend, IN 46624-1241 Ph: (855) 691-9888 | Daniel L Sullivan, MD 600 East Blvd, Elkhart, IN 46514-2483 Ph: (574) 523-3160 |
Nicole S Brunette, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 600 East Blvd, Emergency Department, Elkhart, IN 46514 Phone: 574-523-3161 Fax: 574-273-1137 | |
Matthew Terrence Michalski, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 600 East Blvd, Elkhart, IN 46514 Phone: 574-523-3160 | |
Dr. Jenna Renee Nofziger, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 600 East Blvd, Elkhart, IN 46514 Phone: 574-294-2621 | |
Dr. Scott E Ludwig, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 600 East Blvd, Emergency Department, Elkhart, IN 46514 Phone: 574-271-2558 | |
Randall J Cammenga, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 600 East Blvd, Elkhart, IN 46514 Phone: 574-523-3161 Fax: 574-523-3221 | |
David Erazo, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 600 East Blvd, Elkhart, IN 46514 Phone: 574-523-3161 | |
Ms. Halsey Anne Heinselman, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 600 East Blvd, Emergency Department, Elkhart, IN 46514 Phone: 574-523-3161 |