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NPI Code Detail

MEDICARE: DR. JOAN H SUTCLIFFE M.D.

MEDICARE: DR. JOAN H SUTCLIFFE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician9633NH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1871597799
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOAN H SUTCLIFFE M.D.
Provider Business Mailing Address
First Line : 11995 SINGLETREE LN STE 500
Second Line :
City : EDEN PRAIRIE
State : MN
Zip : 55344-5349
Country : US
Telephone Number : 952-595-1301
Fax Number : 612-294-4903
Provider Business Practice Location Address
First Line : 11995 SINGLETREE LN STE 500
Second Line :
City : EDEN PRAIRIE
State : MN
Zip : 55344-5349
Country : US
Telephone Number : 952-595-1301
Fax Number : 612-294-4903
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2005
Last Update Date : 06/25/2021

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