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1972560407

NPI Code Detail

MEDICARE: DR. FREDERICK SCOTT SUTHERLAND MD

MEDICARE: DR. FREDERICK SCOTT SUTHERLAND 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
1	207W00000X	Ophthalmology Physician	32212	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
8	180021443	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10478	OTHER	NC	KANAWHA
2	376583	OTHER	NC	MAMSI
3	11092	OTHER	NC	BCBS MEDPOINT
4	000000295033	OTHER	SC	UNISON HEALTH PLAN SC
5	100705	OTHER	NC	WELLNESS
6	20093347	OTHER	SC	SELECT HEALTH OF SC
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	36362	OTHER	NC	MEDCOST
10	141018	OTHER	NC	COVENTRY
11	2630782002	OTHER	NC	CIGNA
12	81056	OTHER	NC	BCBS
13	6182	OTHER	NC	DOCTORS HEALTH PLAN
14	6679	OTHER	NC	PARTNERS
15	7472	OTHER	NC	WELLPATH
16	0841437	OTHER	NC	UNITED HEALTHCARE
17	4116519	OTHER	NC	AETNA
18	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972560407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FREDERICK SCOTT SUTHERLAND MD

Provider Business Mailing Address
First Line	:	6035 FAIRVIEW RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28210-3256
Country	:	US
Telephone Number	:	704-295-3000
Fax Number	:

Provider Business Practice Location Address
First Line	:	6035 FAIRVIEW RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28210-3256
Country	:	US
Telephone Number	:	704-295-3650
Fax Number	:	704-295-3666

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	08/25/2022

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Directions to “ DR. FREDERICK SCOTT SUTHERLAND MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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