Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SHANE SULLIVAN
Active Sole ProprietorSHANE SULLIVAN is a Sports Medicine (PM&R) healthcare provider located in DURHAM, North Carolina. NPI 1184339699 is currently active in the NPPES registry. Verify at CMS.
Sports Medicine (PM&R) · DURHAM, NC
Registration Details
- NPI Number
- 1184339699
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 18, 2023 (3.6122086460225 yrs)
- Last Updated
- Jan 18, 2023
- License
-
P21873 (NC)
- Sole Proprietor
- Yes
Practice Information
- Address
-
4221 GARRETT RDDURHAM, NC, 277073467Browse NC providers · Browse ZIP 27707
- Phone
- 9199379607
- Primary Specialty
-
Sports Medicine (PM&R)
2081S0010X
Other Sports Medicine (PM&R) Providers in DURHAM, NC
| Name | Credential | NPI |
|---|---|---|
| HANNA CLAY LYONS | PT | 1447615190 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.