Individual
JEWELLE R SUTHERLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
141 ROUTE 70 E STE B, MARLTON, NJ 08053-1855
(856) 596-9057
(856) 596-0837
Mailing address
301 LIPPINCOTT DR STE 410, MARLTON, NJ 08053-4197
(856) 355-0340
(856) 355-0330
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25MA06384400
NJ
207RP1001X
Pulmonary Disease Physician
Primary
25MA06384400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001443342
IND BC PPO
NJ
01
—
2127243000
AMERIHEALTH HMO
NJ
05
—
7324006
—
NJ
01
—
CB7268
RAILROAD MEDICARE
NJ
Enumeration date
10/25/2005
Last updated
10/22/2020
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