Individual
MATTHEW ROBERT SUTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7950 W JEFFERSON BLVD, SUITE 2121, FORT WAYNE, IN 46804-4140
(260) 435-7937
(260) 435-7933
Mailing address
7950 W JEFFERSON BLVD, SUITE 2121, FORT WAYNE, IN 46804-4140
(260) 435-7937
(260) 435-7933
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01049247A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000088926
ANTHEM
IN
05
—
00278190
—
IN
01
—
930093191
RAILROAD
IN
Enumeration date
07/16/2006
Last updated
07/11/2024
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