Individual
DR. STEPHEN RAYMOND SUTHERLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
165 W. CENTER ST., #401, MARION, OH 43302-3741
(740) 382-4121
Mailing address
PO BOX 446, MARION, OH 43301-0446
(740) 341-5869
Taxonomy
Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
35-053397
OH
2084N0400X
Neurology Physician
Primary
35-053397
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0625658
—
OH
Enumeration date
03/09/2006
Last updated
11/29/2012
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