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General NPI Number Information
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NPI Number | 1205285244
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Entity Type | Organization
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Legal Business Name | DALE F SUTHERLAND MD LLC
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Dates
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Enumeration Date | 06/10/2016
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Last Update Date | 06/13/2016
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Provider Practice Location Address
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Address Line | 18941 JOHN J WILLIAMS HWY
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City | REHOBOTH BEACH
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State | DE
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Zip | 19971-4404
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Country | US
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Telephone | 302-644-6992
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Fax |
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Provider Business Mailing Address
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Address Line | 255 W MICHIGAN AVE PO BOX 1123
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City | JACKSON
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State | MI
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Zip | 49201-2218
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Country | US
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Telephone | 800-516-5315
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DALE F SUTHERLAND
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Credential | MD
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Telephone | 302-381-1087
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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