Provider Demographics
NPI:1578552089
Name:SULLIVAN, STEVEN GARRETT (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:GARRETT
Last Name:SULLIVAN
Suffix:
Gender:M
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:PO BOX 3274
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80155-3274
Mailing Address - Country:US
Mailing Address - Phone:720-870-7446
Mailing Address - Fax:720-870-7460
Practice Address - Street 1:14100 E ARAPAHOE RD
Practice Address - Street 2:SUITE B110
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-4028
Practice Address - Country:US
Practice Address - Phone:720-870-7446
Practice Address - Fax:720-870-7460
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO26715207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01267152Medicaid
COC808386Medicare PIN
CO304313Medicare PIN
COA50408Medicare UPIN
COCOA103841Medicare PIN
COCOA103844Medicare PIN
COC304007Medicare PIN