Healthcare Provider Details

I. General information

NPI: 1386870574
Provider Name (Legal Business Name): AMANDA KAY SUTHERLAND M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2009
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8424 ZINC AUTUMN PATH
RALEIGH NC
27615-4978
US

IV. Provider business mailing address

8424 ZINC AUTUMN PATH
RALEIGH NC
27615-4978
US

V. Phone/Fax

Practice location:
  • Phone: 832-374-8105
  • Fax:
Mailing address:
  • Phone: 832-374-8105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number39060
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: