Basic Information
| Provider Information | |||||||||
| NPI: | 1245331461 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SUTHERLAND | ||||||||
| FirstName: | SHARON | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 301 LINDENWOOD DRIVE | ||||||||
| Address2: | SUITE 350 | ||||||||
| City: | MALVERN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19355 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2155902897 | ||||||||
| FaxNumber: | 2155900325 | ||||||||
| Practice Location | |||||||||
| Address1: | 225 COBBS CREEK PARKWAY | ||||||||
| Address2: | CHOP PRIMARY CARE CENTER-COBBS CREEK | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191393723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154762223 | ||||||||
| FaxNumber: | 2154763981 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/26/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | MD 429653 | PA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.