Individual
JAMES MICHAEL SUTTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
915 MEZZANINE DR, SUITE A, LAFAYETTE, IN 47905-8637
(765) 448-8000
(765) 838-6350
Mailing address
1200 W WHITE RIVER BLVD, MUNCIE, IN 47303-4988
(877) 668-5621
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
01037260A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000197899
ANTHEM PROVIDER NUMBER
IN
05
—
100232550
—
IN
01
—
10826030
CAQH NUMBER
IN
01
—
9397536
PHCS PID PROVIDER
IN
05
—
SU15694039
—
IN
Enumeration date
03/21/2006
Last updated
02/26/2021
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