Shane Sullivan
Shane Sullivan is a Sports Medicine (Physical Medicine & Rehabilitation) Physician in Durham, North Carolina. Practices as a sole proprietor. Licensed in North Carolina.
- Licensed in
- NC
- In the registry since
- 2023
Practice location Address checks out
4221 Garrett RdDurham, NC 27707-3467
Phone: (919) 937-9607
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Sports Medicine (Physical Medicine & Rehabilitation) Physician (primary) | Taxonomy 2081S0010X · Licence P21873 (NC) |
|---|
Record details
| NPI number | 1184339699 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | January 18, 2023 |
| Last updated in NPPES | January 18, 2023 |
| Certification date | January 18, 2023 |
| Mailing address | 1611 Chesborough Rd, Winston Salem, NC 27127-7317 |
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