Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 121871 | OH |
Y | 208600000X | Surgeon | 121871 | OH |
NPI | 1003137233 |
---|---|
Provider Name | Dr. Rachael C Sullivan |
First Address | Beachwood, OH 44122-1745 |
Second Address | Cleveland, OH 44195-1267 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2010 |
Last Update Date | 02/05/2019 |