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Individual

DR. JOHN IVAN SUTTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA03777100
NJ
2080A0000X
Pediatric Adolescent Medicine Physician
MA037771
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
223674880
HMO
NJ
05
3078302
NJ
Enumeration date
08/16/2005
Last updated
09/27/2024
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