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General NPI Number Information
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NPI Number | 1376645580
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Entity Type | Individual
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Provider Name | MICHAEL J SUTTON DO
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Gender | Male
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Dates
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Enumeration Date | 09/01/2006
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Last Update Date | 10/24/2011
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Provider Practice Location Address
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Address Line | 705 N 8TH AVE SUITE 1B
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City | DILLON
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State | SC
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Zip | 29536-2549
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Country | US
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Telephone | 843-487-1588
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Fax | 843-487-1597
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Provider Business Mailing Address
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Address Line | PO BOX 3239
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City | FLORENCE
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State | SC
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Zip | 29502-3239
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Country | US
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Telephone | 843-841-3517
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Fax | 843-841-3519
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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 | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | MS007501
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 457
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License Number State | SC
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