Sutherland, Carisa M
Sutherland, Carisa M is an individual health care provider with primary practice located at 231 S Sharon Amity Rd , Charlotte NC 28211-2803. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Adolescent Medicine, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Sutherland, Carisa M can be contacted via phone (704) 304-6400.Contact Information
Primary practice address
231 S Sharon Amity Rd
Charlotte NC 28211-2803
Phone: (704) 304-6400
Fax: (704) 442-7021
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Adolescent Medicine | 2080A0000X | 2007-00120 | North Carolina |
| Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine | 2080P0204X | 2007-00120 | North Carolina |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 2007-00120 | North Carolina |
Profile Details
| NPI number | 1639194764 |
|---|---|
| LBN Legal business name | Sutherland, Carisa M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 12th, 2006 |
| Last updated | Oct 28th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639194764 | NPPES |
| South Carolina | MEDICAID | N0012B | |
| South Carolina | MEDICAID | 1639194764 | |
| South Carolina | MEDICAID | 5906365 |
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