Healthcare Provider Details

I. General information

NPI: 1063631141
Provider Name (Legal Business Name): MICHELLE RENEE ESTEP M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE RENEE SUTTON M.D.

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4011 GATEWAY BLVD
NEWBURGH IN
47630-8947
US

IV. Provider business mailing address

PO BOX 3407
EVANSVILLE IN
47733-3407
US

V. Phone/Fax

Practice location:
  • Phone: 812-842-3880
  • Fax: 812-842-3916
Mailing address:
  • Phone: 812-842-3880
  • Fax: 812-842-3916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number69521
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number01071245A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number118827
License Number StateMT
# 4
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number01071245A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: