Provider Demographics
NPI:1659695088
Name:SUTTON, NOAH THOMAS (MD)
Entity Type:Individual
Prefix:
First Name:NOAH
Middle Name:THOMAS
Last Name:SUTTON
Suffix:
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 1:35 MEDICAL CENTER PKWY STE 201
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-8160
Mailing Address - Country:US
Mailing Address - Phone:207-620-1136
Mailing Address - Fax:
Practice Address - Street 1:35 MEDICAL CENTER PKWY STE 201
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330
Practice Address - Country:US
Practice Address - Phone:207-620-1136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-13
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE26726207L00000X
MDD0078701207L00000X
VA0101256209207L00000X
MEMD22040207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology