Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Benjamin M Sullivan, PA-C

Individual provider Physician Assistant · NPI 1578226304

Benjamin M Sullivan, PA-C is a Physician Assistant in Troy, Michigan. Works from 2 locations. Licensed in Michigan and New York.

Licensed in
MI, NY
In the registry since
2021
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

44201 Dequindre Rd
Troy, MI 48085-1117
Phone: (248) 964-5000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1215 E Michigan Ave, Lansing, MI 48912-1811 — (517) 364-1000

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601010852 (MI)
Physician Assistant Taxonomy 363A00000X · Licence 032145 (NY)

Record details

NPI number1578226304
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 19, 2021
Last updated in NPPESSeptember 12, 2025
Certification dateSeptember 12, 2025
Mailing address26901 Beaumont Blvd Ste 3d, Southfield, MI 48033-3849

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