Provider Demographics
NPI:1154582146
Name:SULLIVAN, ELIZABETH HOWE (MD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:HOWE
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 US ROUTE 1 STE 2
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-7219
Mailing Address - Country:US
Mailing Address - Phone:207-396-7606
Mailing Address - Fax:207-819-6802
Practice Address - Street 1:144 US ROUTE 1 STE 2
Practice Address - Street 2:
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-7219
Practice Address - Country:US
Practice Address - Phone:207-396-7606
Practice Address - Fax:207-819-6802
Is Sole Proprietor?:No
Enumeration Date:2008-06-23
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2685512086S0102X
MEMD20834208600000X
WI77166-20208600000X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine