Individual
GREGORY M SUTLIFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
811 W 2ND ST, BLOOMINGTON, IN 47403-2212
(812) 333-4001
Mailing address
550 S LANDMARK AVE, BLOOMINGTON, IN 47403-3239
(812) 331-3401
(812) 335-0027
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01044377A
IN
207RC0000X
Cardiovascular Disease Physician
01044377A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200060830
—
IN
Enumeration date
06/16/2005
Last updated
12/18/2019
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