| Dr Brian Patrick Sullivan, MD | |
| 
					2799 W Grand Blvd, Detroit, MI 48202-2608  | |
| (313) 916-2600 | |
| (313) 876-1305 | 
| Full Name | Dr Brian Patrick Sullivan | 
|---|---|
| Gender | Male | 
| Speciality | Surgery - Vascular Surgery | 
| Location | 2799 W Grand Blvd, Detroit, Michigan | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1770145401 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 2086S0129X | Surgery - Vascular Surgery | 2019021935 (Missouri) | Secondary | 
| 2086S0129X | Surgery - Vascular Surgery | 4301512530 (Michigan) | Primary | 
| Entity Name | Henry Ford Health System | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1134144801 PECOS PAC ID: 0547178311 Enrollment ID: O20031105000139  | 
| Entity Name | Henry Ford Wyandotte Hospital | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1457586646 PECOS PAC ID: 2264334499 Enrollment ID: O20040227000431  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Brian Patrick Sullivan, MD 1 Ford Pl Ste 3a, Detroit, MI 48202-3450 Ph: (313) 874-4553  | Dr Brian Patrick Sullivan, MD 2799 W Grand Blvd, Detroit, MI 48202-2608 Ph: (313) 916-2600  | 
Kaitlyn Dobesh, MD Surgery Medicare: Medicare Enrolled Practice Location: 2799 W Grand Blvd, Detroit, MI 48202 Phone: 313-916-2600  | |
Dr. Bellal Ali Joseph, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 2799 W Grand Blvd, Detroit, MI 48202 Phone: 313-916-3056 Fax: 313-916-9920  | |
Charles Edward Lucas, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 4160 John R St, Suite 615, Detroit, MI 48201 Phone: 313-745-4195 Fax: 313-993-8669  | |
Christopher Paul Cassell, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 22101 Moross Rd, Detroit, MI 48236 Phone: 313-343-4000  | |
Mitchell Ross Weaver, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 2799 W Grand Blvd, Detroit, MI 48202 Phone: 313-916-3156 Fax: 313-916-3023  | |
Alexander Marinica,  Surgery Medicare: Accepting Medicare Assignments Practice Location: 6071 W Outer Dr Ste 121, Detroit, MI 48235 Phone: 313-966-3222  | |
Dr. Rachel Wobig, MD Surgery Medicare: Medicare Enrolled Practice Location: 2799 W Grand Blvd, Detroit, MI 48202 Phone: 313-916-5071 Fax: 313-916-9920  |