C EUGENE SULLIVAN M.D.
NPI 1649453903
Specialist in Boise, ID

Active since December 10, 2007
210 W JEFFERSON ST, BOISE, ID 83702(208) 344-9424(208) 343-3263 Get Directions Write a Review

NPPES record last updated: December 10, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About C Eugene Sullivan M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

C EUGENE SULLIVAN M.D. (NPI 1649453903) is an individual specialist in Boise, Idaho, licensed in Idaho (M3232) and active in the NPI registry since December 2007.

NPPES Registry Identity

NPI1649453903
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameC EUGENE SULLIVANCredential: M.D.
Location Address210 W JEFFERSON STBoise, ID 83702-6044
Mailing AddressPo Box 2066Boise, ID 83701-2066 · (208) 344-9424 · Fax (208) 344-3263
Fax(208) 343-3263
Sole ProprietorYes
Enumeration DateDecember 10, 2007
NPI 1649453903 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License Licensed in ID · M3232
Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

210 W JEFFERSON ST, Boise, ID 83702

Other Identifiers 2

Medicaid0024588ID
Medicare UPINE08600ID

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner
210 W JEFFERSON ST
BOISE, ID 83702

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is C Sullivan's NPI number?

The NPI number for C Sullivan is 1649453903. It was assigned to this individual provider in the NPPES registry on December 10, 2007.

Where is C Sullivan located?

C Sullivan practices at 210 W Jefferson St, Boise, ID 83702. The listed phone number is (208) 344-9424.

What is C Sullivan's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for C Sullivan was last updated on December 10, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.