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NPI Code Detail

MEDICARE: LADDEUS L SUTTON MD

MEDICARE: LADDEUS L SUTTON MD
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
1207RC0000XCardiovascular Disease Physician9300332NC

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 : 1891793139
Entity Type Code : Individual
Provider Name (Legal Business Name) : LADDEUS L SUTTON MD
Provider Business Mailing Address
First Line : PO BOX 744786
Second Line :
City : ATLANTA
State : GA
Zip : 30374-4786
Country : US
Telephone Number : 704-834-2450
Fax Number : 704-671-5331
Provider Business Practice Location Address
First Line : 2555 COURT DR STE 200
Second Line :
City : GASTONIA
State : NC
Zip : 28054-2178
Country : US
Telephone Number : 704-868-3256
Fax Number : 704-868-5870
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2005
Last Update Date : 08/12/2019

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Directions to “ LADDEUS L SUTTON MD” Practice Location

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