Provider Demographics
NPI:1467458232
Name:SUTHERLAND, JAMES C JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:C
Last Name:SUTHERLAND
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 JOHNSTON WILLIS DR
Mailing Address - Street 2:STE 1200
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-4730
Mailing Address - Country:US
Mailing Address - Phone:804-323-1401
Mailing Address - Fax:804-323-1850
Practice Address - Street 1:8201 ATLEE RD
Practice Address - Street 2:STE B
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-1815
Practice Address - Country:US
Practice Address - Phone:804-730-5222
Practice Address - Fax:804-730-5225
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101040477207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5837707Medicaid
VA660000064Medicare ID - Type Unspecified
VA5837707Medicaid