# DR. MICHAEL SUTPHIN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1871693838
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 166834-1205 | UT | — |
| 208800000X | Urology Physician | 3547A | WY | Yes |
| 208800000X | Urology Physician | G42452 | CA | — |

## Other

- **Enumeration date:** 09/22/2006
- **Last updated:** 11/19/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 104849000 | — | WY |
| 01 | — | 1312335 | UMWA | WY |
| 01 | — | 2266 | BCBS-WY | WY |
| 01 | — | 340001047 | UPREHA | WY |