Individual
JOHN DOUGLAS SUTTERLIN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7 S ALLIANCE DR STE 211B, GOOSE CREEK, SC 29445-7269
(843) 553-4383
(843) 553-4384
Mailing address
PO BOX 530062, ATLANTA, GA 30353-0062
(843) 695-6071
(843) 569-5879
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17955
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080187342
RR MEDICARE
SC
05
—
179550
—
SC
Enumeration date
05/17/2006
Last updated
06/10/2021
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