Healthcare Provider Details

I. General information

NPI: 1154254142
Provider Name (Legal Business Name): CAROLINE E SUDDATH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 WESTWOOD AVE
HIGH POINT NC
27262-4341
US

IV. Provider business mailing address

8 W 3RD ST APT 503
WINSTON SALEM NC
27101-3974
US

V. Phone/Fax

Practice location:
  • Phone: 336-878-6009
  • Fax:
Mailing address:
  • Phone: 813-995-1220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: