Individual
DR. DAVID WAYNE SUETHOLZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2378 GRANDVIEW DR, FORT MITCHELL, KY 41017-1633
(859) 341-1122
(859) 341-1171
Mailing address
2378 GRANDVIEW DR, FORT MITCHELL, KY 41017-1633
(859) 341-1122
(859) 341-1171
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
18013
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0280360
—
OH
05
—
64180136
—
KY
Enumeration date
04/07/2006
Last updated
03/15/2017
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