Individual
JEROME C SUTHERLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 E HAMPDEN AVE, ENGLEWOOD, CO 80113-2703
(303) 761-9190
Mailing address
10700 E GEDDES AVE, NO 200, ENGLEWOOD, CO 80112-3800
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
14605
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01146059
—
CO
05
—
053218601
—
TX
05
—
1023064706
—
CA
05
—
1023064706
—
WY
05
—
104686392
—
MI
05
—
200425440A
—
KS
05
—
2315994
—
LA
01
—
300049155
RR RIA MCRE
CO
01
—
300090380
RR MIC MCRE
CO
05
—
84-059792913
—
NE
05
—
920448
—
AZ
05
—
99112107
—
WI
Enumeration date
05/25/2006
Last updated
02/11/2013
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