Doctor Name: | DR. SHANNON DANIELLE SULLIVAN |
NPI Number: | 1033377445 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 0101242009 |
Business Practice Address: | 3800 Reservoir Rd Nw Washington, DC - 200072113 |
Business Phone Number: | 2024442600 |
Business Fax Number: | 2024444859 |
Mailing Address: | 1526 17th St Nw, #402 WASHINGTON |
State: | DC |
Postal Code: | 200366216 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/02/2008 |
NPI Last Update Date: | 02/08/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 0101242009 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | VA |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |