Provider Demographics
NPI:1730137860
Name:SUTKER, LAWRENCE H (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:H
Last Name:SUTKER
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:PO BOX 2500
Mailing Address - Street 2:
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24402-2500
Mailing Address - Country:US
Mailing Address - Phone:540-332-8000
Mailing Address - Fax:866-422-1175
Practice Address - Street 1:1301 RICHMOND ROAD
Practice Address - Street 2:WESTERN STATE HOSPITAL
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24402-2500
Practice Address - Country:US
Practice Address - Phone:540-332-8000
Practice Address - Fax:866-422-1175
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010314212084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAB07477Medicare UPIN
VA260002790Medicare ID - Type Unspecified