Individual
PAMELA SUTHERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
700 S STANFIELD RD STE A, TROY, OH 45373
(937) 339-5355
(937) 339-3056
Mailing address
700 S STANFIELD RD STE A, TROY, OH 45373-2569
(937) 339-5355
(937) 339-3056
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
50-00-1250
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0160410
—
OH
Enumeration date
02/01/2007
Last updated
11/18/2020
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