Dr. Gerald Edward Sullivan
Internist Internist - Addiction Medicine
6040 W Lisbon Ave Suite 200
Milwaukee
, Wisconsin 53210-2116
Dr. Gerald Edward Sullivan
Internist Internist - Addiction Medicine
6040 W Lisbon Ave Suite 200
Milwaukee
, Wisconsin 53210-2116
(262) 306-1997
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About
Features
Specialties
- Internist
- Internist - Addiction Medicine
Languages spoken
- English
Location
First Address
- Dr. Gerald Edward Sullivan
- 1169 N 13th Ave
- West Bend, WI
- Zip : 53090-1701
- Phone : (262) 306-1997
Second Address
- Dr. Gerald Edward Sullivan
- 6040 W Lisbon Ave Suite 200
- Milwaukee, WI
- Zip : 53210-2116
- Fax : (414) 447-9891
- Phone : (414) 447-9890
Reviews
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207R00000X | Internist | 37202 | WI |
| Y | 111NI0900X | Internist | 37202 | WI |
| N | 207RA0401X | Internist - Addiction Medicine | 37202 | WI |
National Provider Identifier
| NPI | 1760683551 |
|---|---|
| Provider Name | Dr. Gerald Edward Sullivan |
| First Address | West Bend, WI 53090-1701 |
| Second Address | Milwaukee, WI 53210-2116 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 30/05/2007 |
| Last Update Date | 12/08/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 32475500 | (05) | WI |
| G64015 | (02) | WI |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.