Provider Demographics
NPI:1659631018
Name:SULLIVAN, PATRICK SEAN (DVM)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:SEAN
Last Name:SULLIVAN
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1628 RAINIER FALLS DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-4108
Mailing Address - Country:US
Mailing Address - Phone:404-210-6039
Mailing Address - Fax:866-311-8234
Practice Address - Street 1:1628 RAINIER FALLS DR NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-4108
Practice Address - Country:US
Practice Address - Phone:404-210-6039
Practice Address - Fax:866-311-8234
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-20
Last Update Date:2012-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAVET005024174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian