Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VX0201X | Gynecologic Oncologist | 01032586 | IN |
Y | 207VX0201X | Gynecologic Oncologist | 4301111311 | MI |
NPI | 1568409373 |
---|---|
Provider Name | Gregory P Sutton |
First Address | Saginaw, MI 48602-4727 |
Second Address | Saginaw, MI 48604-9515 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2006 |
Last Update Date | 26/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100074000 | (05) | IN |
C24456 | (02) |