Dr Kerry Sullivan, DO | |
11995 Singletree Ln Ste 500, Eden Prairie, MN 55344-5349 | |
(952) 595-1301 | |
(612) 294-4903 |
Full Name | Dr Kerry Sullivan |
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Gender | Male |
Speciality | Radiology - Diagnostic Radiology |
Location | 11995 Singletree Ln Ste 500, Eden Prairie, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1093717548 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2085R0202X | Radiology - Diagnostic Radiology | 34003443 (Ohio) | Primary |
Entity Name | Clinic Medical Services Company |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1528013984 PECOS PAC ID: 5698674653 Enrollment ID: O20040108000271 |
Mailing Address | Practice Location Address |
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Dr Kerry Sullivan, DO 11995 Singletree Ln Ste 500, Eden Prairie, MN 55344-5349 Ph: (952) 595-1301 | Dr Kerry Sullivan, DO 11995 Singletree Ln Ste 500, Eden Prairie, MN 55344-5349 Ph: (952) 595-1301 |
Norna L. Karp, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 11995 Singletree Ln Ste 500, Eden Prairie, MN 55344 Phone: 952-595-1301 Fax: 612-294-4903 | |
Christopher Calixte, MD Radiology Medicare: Medicare Enrolled Practice Location: 11995 Singletree Ln Ste 500, Eden Prairie, MN 55344 Phone: 952-595-1301 Fax: 612-294-4903 | |
Paul D Guisler, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 11995 Singletree Ln Ste 500, Eden Prairie, MN 55344 Phone: 952-595-1301 Fax: 612-294-4903 | |
Rati N Patel, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 11995 Singletree Ln Ste 500, Eden Prairie, MN 55344 Phone: 952-595-1301 Fax: 612-294-4903 | |
Jacob Gebrael, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 11995 Singletree Ln Ste 500, Eden Prairie, MN 55344 Phone: 952-595-1301 Fax: 612-294-4903 | |
Susanne S. Kim, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 11995 Singletree Ln Ste 500, Eden Prairie, MN 55344 Phone: 952-595-1301 Fax: 612-294-4903 | |
Gwendolyn Durgin, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 11995 Singletree Ln Ste 500, Eden Prairie, MN 55344 Phone: 952-595-1301 Fax: 612-294-4903 |