| Shawn M Sullivan Do Pc | |
|
3295 N Drinkwater Blvd Ste 5 Scottsdale AZ 85251-6437 | |
| (480) 949-0298 | |
| (480) 949-1258 |
| Full Name | Shawn M Sullivan Do Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 3295 N Drinkwater Blvd Ste 5, Scottsdale, Arizona |
| Authorized Official Name and Position | Shawn Michael Sullivan (PHYSICIAN) |
| Authorized Official Contact | 4809490298 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shawn M Sullivan Do Pc 3295 N Drinkwater Blvd Ste 5 Scottsdale AZ 85251-6437 Ph: (480) 949-0298 | Shawn M Sullivan Do Pc 3295 N Drinkwater Blvd Ste 5 Scottsdale AZ 85251-6437 Ph: (480) 949-0298 |
| NPI Number | 1962781948 |
|---|---|
| Provider Enumeration Date | 08/09/2011 |
| Last Update Date | 03/03/2021 |
| Medicare PECOS PAC ID | 9739460544 |
|---|---|
| Medicare Enrollment ID | O20170109003088 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962781948 | NPI | - | NPPES |
| 459009 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 3270 (Arizona) | Primary |
| Provider Name | Shawn M Sullivan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972544450 PECOS PAC ID: 4183644701 Enrollment ID: I20051129000049 |
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