P Praxis·MD
● Active Type 1 · Individual

C Eugene Sullivan, M.D.

Specialist·Boise, ID· NPI 1649453903 · Enumerated 2007 · 18 years on NPI
Sullivan is 1 of 67 specialist providers in Boise and 1 of 305 in Idaho.
NPI age
18 years
Enumerated 2007-12-10
Primary specialty
Specialist
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2007-12-10
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file

How this provider compares

Across 305 active specialist providers in Idaho.

NPI age
18 years
≈ at median (18 yr)
State licenses
1 state
2% of peers hold multiple states
Subspecialties
0
11% of peers hold subspecialties

NPI lifetime · 2007 → 2026

2007-12Enumerated in NPPES
2007 2026

Where they practice

Practice location
210 W Jefferson St
Boise, ID 837026044
📞 2083449424fax 2083433263
Mailing address
Po Box 2066
Boise, ID 837012066
📞 2083449424fax 2083443263

Specialties

  • Specialist Primary
    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.
    ID license #M3232 taxonomy 174400000X

Identifiers

TypeValueNotes
05 (ID) 0024588

Practice context

Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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