Individual
DR. CHARLES SUTHERLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2101 CORONA RD STE 102, COLUMBIA, MO 65203-2582
(573) 234-1800
Mailing address
2101 CORONA RD STE 102, COLUMBIA, MO 65203-2582
(573) 234-1800
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
113731
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
245101407
—
MO
Enumeration date
03/09/2006
Last updated
07/21/2023
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