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General NPI Number Information
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NPI Number | 1508981333
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Entity Type | Individual
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Provider Name | STEVEN JOHN SUTHERLAND MD
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Gender | Male
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 09/11/2018
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Provider Practice Location Address
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Address Line | 400 EAST 3RD STREET ESESNTIA HEALTH-DULUTH CLINIC
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City | DULUTH
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State | MN
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Zip | 55805
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Country | US
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Telephone | 218-786-1186
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Fax | 218-728-4404
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Provider Business Mailing Address
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Address Line | 400 EAST 3RD STREET ESSENTIA HEALTH-DULUTH CLINIC
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City | DULUTH
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State | MN
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Zip | 55805
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Country | US
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Telephone | 218-786-8364
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Fax | 218-728-4404
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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 | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 33578
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 39439
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License Number State | MN
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