Individual provider · Type 1 NPI

Benjamin Jacob Sullivan, PA-C

Medical Physician Assistant · Greensboro, NC

NPI number 1710684758 Active

Practice location

2005 Pisgah Church Rd
Greensboro, NC 27455-3309

Call (336) 716-9150 Map

Fax (336) 702-9166

Other practice locations

  • 200 Hawkins Dr, Iowa City, IA 52242-1009 · (319) 356-2233

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000X0010-16580 (NC)
Medical Physician Assistant Primary 363AM0700X129254 (IA)

Medical Physician Assistant: Definition to come...

13 other providers at this address

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About NPI 1710684758

Benjamin Jacob Sullivan, PA-C's National Provider Identifier is 1710684758, issued on Feb 9, 2023. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Greensboro, NC. The record was last updated on Sep 15, 2026.