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General NPI Number Information
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NPI Number | 1033191002
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Entity Type | Individual
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Provider Name | MARK EUGENE SUTTER M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/16/2005
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Last Update Date | 01/30/2008
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Provider Practice Location Address
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Address Line | 550 PEACHTREE ST NE EMORY UNIVERSITY CRAWFORD LONG HOSPITAL
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City | ATLANTA
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State | GA
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Zip | 30308
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Country | US
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Telephone | 404-778-7777
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Fax |
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Provider Business Mailing Address
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Address Line | 1760 RIDGEWOOD DR NE
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City | ATLANTA
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State | GA
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Zip | 30307-1164
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Country | US
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Telephone | 404-377-4368
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | A84548
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License Number State | CA
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