Individual
CARISA MARICE SUTHERLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
231 S SHARON AMITY RD, CHARLOTTE, NC 28211-2803
(704) 304-6400
(704) 442-7021
Mailing address
PO BOX 602148, CHARLOTTE, NC 28260-2148
(704) 304-6400
(704) 442-7021
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2007-00120
NC
2080A0000X
Pediatric Adolescent Medicine Physician
2007-00120
NC
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
2007-00120
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639194764
—
NC
05
—
5906365
—
NC
05
—
N0012B
—
SC
Enumeration date
07/12/2006
Last updated
03/24/2025
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