Individual
DR. PAUL SUTHERLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 HARRIS DRIVE, KILMARNOCK, VA 22482
(804) 435-8000
Mailing address
PO BOX 2244, KILMARNOCK, VA 22482-2244
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101043104
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020037
ANTHEM BCBS
VA
01
—
930025689
RR MEDICARE
VA
01
—
CAQH
10407068
VA
Enumeration date
08/11/2006
Last updated
07/22/2014
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