Kenneth Sullivan, MD in Berlin, WI - Surgery

Kenneth Sullivan, MD is a Surgery physician based in Berlin, Wisconsin. Kenneth Sullivan is licensed to practice in Wisconsin (license number 40493-020) and his current practice location is 225 Memorial Dr, Berlin, Wisconsin. He can be reached at his office (for appointments etc.) via phone at (920) 361-5525.

NPI number for Kenneth Sullivan is 1902899917 and his current mailing address is 225 Memorial Dr, Berlin, Wisconsin. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1902899917.

Contact Information

	Kenneth Sullivan, MD
	225 Memorial Dr, Berlin, WI 54923-1243
	(920) 361-5525
	Not Available

Physician's Profile

Full Name	Kenneth Sullivan
Gender	Male
Speciality	Surgery
Location	225 Memorial Dr, Berlin, Wisconsin
Accepts Medicare Assignments	Does not participate in Medicare Program. He may not accept medicare assignment.

NPI Data:

NPI Number: 1902899917
Provider Enumeration Date: 08/24/2005
Last Update Date: 07/08/2007

Medical Identifiers

Medical identifiers for Kenneth Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1902899917	NPI	-	NPPES
32483800	Medicaid	WI

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207P00000X	Emergency Medicine	40493-020 (Wisconsin)	Primary
207Q00000X	Family Medicine	40493-020 (Wisconsin)	Primary
208600000X	Surgery	40493-020 (Wisconsin)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kenneth Sullivan is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Kenneth Sullivan, MD 225 Memorial Dr, Berlin, WI 54923-1243 Ph: (920) 361-1313	Kenneth Sullivan, MD 225 Memorial Dr, Berlin, WI 54923-1243 Ph: (920) 361-5525

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Surgery Doctors in Berlin, WI

Barry L Rogers, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 225 Memorial Dr, Ste 2000, Berlin, WI 54923 Phone: 920-361-5340 Fax: 920-361-5335
Dr. Horace Pei Lo, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 225 Memorial Dr Ste 2000, Berlin, WI 54923 Phone: 920-361-5340
Darren G Nelson, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 225 Memorial Dr, Ste 2000, Berlin, WI 54923 Phone: 920-361-5340 Fax: 920-361-5335

Kenneth Sullivan, MD - Surgery in Berlin, WI