Individual
JEROME C SUTHERLAND
Active
Individual
JEROME C SUTHERLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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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