Provider Demographics
NPI:1396915492
Name:SULLIVAN, CRISTINA CRAVEIRO (MD)
Entity type:Individual
Prefix:DR
First Name:CRISTINA
Middle Name:CRAVEIRO
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 1:934 SHIRECLIFF RD
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84108-1447
Mailing Address - Country:US
Mailing Address - Phone:801-205-4115
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF UTAH 30 NORTH 1900 EAST
Practice Address - Street 2:DEPARTMENT OF ANESTHESIOLOGY, ROOM 3C444
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84132-0001
Practice Address - Country:US
Practice Address - Phone:801-581-6393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6054134-1205207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology