Individual
DR. AUDREY LYNN SUTTON-SURAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1013 PORTERS NECK RD, SUITE 100, WILMINGTON, NC 28411
(910) 686-1099
(910) 686-4715
Mailing address
1013 PORTERS NECK RD, SUITE 100, WILMINGTON, NC 28411-8130
(910) 686-1099
(910) 686-4715
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
200501955
NC
207Q00000X
Family Medicine Physician
25MB6325500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1378260
UNITED HEATHCARE
—
01
—
5231159
AETNA
—
05
—
5904062
—
NC
01
—
9614555
CIGNA
—
Enumeration date
11/16/2005
Last updated
08/06/2018
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