Provider Demographics
NPI:1316088503
Name:SULLIVAN, MALGORZATA JOLANTA (MD)
Entity type:Individual
Prefix:DR
First Name:MALGORZATA
Middle Name:JOLANTA
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2900 TELESTAR CT
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-1206
Mailing Address - Country:US
Mailing Address - Phone:703-531-1106
Mailing Address - Fax:703-852-7389
Practice Address - Street 1:50 F ST NW
Practice Address - Street 2:SUITE 3300
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-1530
Practice Address - Country:US
Practice Address - Phone:202-244-8300
Practice Address - Fax:202-244-1413
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCMD036370207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine