IndividualActive
Michael Sullivan
NPI 1104215136 · Perfusionist · Cape Girardeau, MO
Provider details
- NPI number
- 1104215136
- Entity type
- Individual
- Primary specialty
- PerfusionistTechnologists, Technicians & Other Technical Service Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 20140118235 (MO)
Practice location
137 Founders Way Ct
Cape Girardeau, MO 63701-9442
Phone: (573) 450-8189
Mailing address
137 Founders Way Ct
Cape Girardeau, MO 63701-9442
Registry dates
- Enumerated
- 2015-01-14
- Last updated
- 2015-01-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.