Individual
RICHARD W SUTTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
725 S ADAMS RD, #243, BIRMINGHAM, MI 48009-6902
(248) 220-1148
(248) 220-1151
Mailing address
7520 SUSSEX DR, CANTON, MI 48187-2238
(734) 927-0009
(734) 927-0009
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601001147
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5601001147
P.A.. LICENSE
MI
01
—
700H231390
BCBS GROUP NUMBER
MI
Enumeration date
08/31/2006
Last updated
04/20/2010
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