Provider Demographics
NPI:1932299096
Name:SUTHERLAND, DAVID ER (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ER
Last Name:SUTHERLAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - Street 2:420 DELAWARE STREET SE
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455
Mailing Address - Country:US
Mailing Address - Phone:612-626-6100
Mailing Address - Fax:
Practice Address - Street 1:516 DELAWARE ST SE
Practice Address - Street 2:PWB SECOND FLOOR, CLINIC 2A
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455-0356
Practice Address - Country:US
Practice Address - Phone:612-626-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN17789208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNHP22207OtherHEALTH PARTNERS
MN17-70132OtherMEDICA PRIMARY
MN084475OtherFAIRVIEW
MN101561OtherUCARE
MN1009322OtherPREFERRED ONE
MN17-24580OtherMEDICA CHOICE
MN2T106SUOtherBLUE CROSS BLUE SHIELD
MN603777OtherARAZ
MNHP22207OtherHEALTH PARTNERS