MR. MACK HUGH SULLIVAN JR. (NPI# 1780683151) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780683151 |
| Entity Type | Individual |
| Full Name | MR. MACK HUGH SULLIVAN JR. |
| Credential | MD |
| Practice Address |
44199 Dequindre Rd. Suite 518 Troy MI 48085 |
| Practice Telephone | 2485240640 |
| Practice Fax Number | 2489940866 |
| Mailing Telephone | 2485240640 |
| Mailing Fax Number | 2489940866 |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2013-01-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208200000X | Plastic Surgery | 4301094101 | MI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881616068 | Mack Lee Sullivan | Emergency Medicine | 150 Lake Ave, Tuckahoe, NY 10707-3306 | 2006-07-24 |
| Street Address |
44199 DEQUINDRE RD. SUITE 518 |
| City | TROY |
| State | MI |
| Zip Code | 48085 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790327252 | Long Lake Rx | Pharmacy | 2888 East Long Lake Rd #120, Suite 120, Troy, MI 48085 | 2019-10-16 |
| 1538712948 | Long Lake Rx | Pharmacy | 2888 East Long Lake Rd, Suite 120, Troy, MI 48085 | 2019-07-24 |
| 1669035093 | William Beaumont Hospital | Pharmacy | Beaumont Hospital Troy, 44201 Dequindre, Room 11a0310, Troy, MI 48085 | 2019-04-22 |
| 1487126926 | Long Lake Rx | Pharmacy | 2888 E Long Lake Rd Suite 120, Troy, MI 48085 | 2018-12-21 |
| 1295226579 | Jeffrey Paul Biehl | Nurse Anesthetist, Certified Registered | 44249 Dequindre Rd., Troy, MI 48085 | 2018-05-23 |
| 1619478666 | Trisha Misiewicz | Physical Therapist | 42201 Dequindre Rd, Troy, MI 48085 | 2018-02-26 |
| 1760900393 | Sensory Rehabilitation LLC | Physical Therapist | 4413, Reilly Ct, Troy, MI 48085 | 2017-09-04 |
| 1841710837 | James L Chang | Dentist | 1883 E Wattles, Troy, MI 48085 | 2017-06-21 |
| 1033567953 | Brittany N David | Physician Assistant | 2041 E Square Lake Rd Suite 300, Troy, MI 48085 | 2016-06-01 |
| 1053784199 | Brianna Lynn Manica | Nurse Practitioner | 44201 Dequindre Rd., Ste. 400 Troy Beaumont Hospital, Troy, MI 48085 | 2015-11-12 |
| Find all providers in zip 48085 | ||||
| Taxonomy Code | 208200000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518306315 | Sarah M Elswick | Plastic Surgery | 201 W Big Beaver Rd Ste 1130, Troy, MI 48084-5298 | 2013-06-14 |
| 1104158013 | Mua Center LLC | Plastic Surgery | 1120 E Long Lake Rd, Suite #105, Troy, MI 48085-4974 | 2010-02-02 |
| 1447266945 | William A Stefani | Plastic Surgery | 85 E Big Beaver Rd, Troy, MI 48083-1262 | 2006-08-01 |
| 1447608104 | Mazen Harake, Md PC | Plastic Surgery | 201 W Big Beaver Rd, Suite 1130, Troy, MI 48084-4152 | 2016-06-02 |
| 1053771857 | Janineh Plastic Surgery PC | Plastic Surgery | 5600 Rochester Rd, Troy, MI 48085-3374 | 2016-03-07 |
| 1376978643 | Ddpmd PC | Plastic Surgery | 755 W Big Beaver Rd, Suite 1200, Troy, MI 48084-4900 | 2013-09-05 |
| 1609208982 | Community Care Physicians, PC | Plastic Surgery | 101 Jordan Rd, Suite 103, Troy, NY 12180-8343 | 2013-08-08 |
| 1619242963 | Steven E Stein Md PC | Plastic Surgery | 1579 W Big Beaver Rd, Suite B-7, Troy, MI 48084-3504 | 2012-03-20 |
| 1629300884 | Federal Medical Services PC | Plastic Surgery | 1120 E Long Lake Rd, Suite # 105, Troy, MI 48085-4974 | 2010-02-12 |
| 1043470982 | Adrian Przybyla | Plastic Surgery | 101 Jordan Rd, Suite 103, Troy, NY 12180-8343 | 2008-06-13 |
| Find all providers in TROY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.