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

Individual provider Internal Medicine Physician · NPI 1174605653

Ryan A Sullivan, MD is an Internal Medicine in Manistee, Michigan. Graduated from Wayne State University School of Medicine in 2002, 24 years ago. Practices with Crystal Lake Clinic PC, a 13-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Michigan.

Years since qualifying
24
Trained at
Wayne State University School of Medicine
Licensed in
MI
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2198 US Highway 31 S
Manistee, MI 49660-9618
Phone: (231) 723-3567
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 430308010 (MI)

Record details

NPI number1174605653
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedOctober 20, 2006
Last updated in NPPESDecember 30, 2020
Certification dateDecember 30, 2020
Mailing address6227 Frankfort Hwy, Benzonia, MI 49616-8632

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolWAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduated 2002 (24 years in practice)
Group practice Crystal Lake Clinic Pc — 13 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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