Individual
DR. MICHAEL SUTPHIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1180 COLLEGE DRIVE, ROCK SPRINGS, WY 82901
(307) 362-4200
(307) 362-5406
Mailing address
1180 COLLEGE DRIVE, ROCK SPRINGS, WY 82901
(307) 362-4200
(307) 362-5406
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
166834-1205
UT
208800000X
Urology Physician
Primary
3547A
WY
208800000X
Urology Physician
G42452
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104849000
—
WY
01
—
1312335
UMWA
WY
01
—
2266
BCBS-WY
WY
01
—
340001047
UPREHA
WY
Enumeration date
09/22/2006
Last updated
11/19/2014
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