Individual provider · Type 1 NPI

C Eugene Sullivan, MD

Specialist · Boise, ID

NPI number 1649453903 Active

Practice location

210 W Jefferson St
Boise, ID 83702-6044

Call (208) 344-9424 Map

Fax (208) 343-3263

Mailing address

PO Box 2066
Boise, ID 83701-2066

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000XM3232 (ID)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1649453903

C Eugene Sullivan, MD's National Provider Identifier is 1649453903, issued on Dec 10, 2007. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Boise, ID. The record was last updated on Dec 10, 2007.