Individual
RYAN SUTHERLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 LAKE AVE NORTH, WORCESTER, MA 01655-0002
(508) 334-3850
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
1020017
MA
2085R0202X
Diagnostic Radiology Physician
D85885
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008656800
—
MD
05
—
039918288
—
DC
Enumeration date
04/04/2016
Last updated
05/23/2024
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