Provider Demographics
NPI:1679375117
Name:SUTTON, MICHAEL PETER (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:PETER
Last Name:SUTTON
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 COOLIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:RANSON
Mailing Address - State:WV
Mailing Address - Zip Code:25438-4527
Mailing Address - Country:US
Mailing Address - Phone:724-900-6630
Mailing Address - Fax:
Practice Address - Street 1:171 TAYLOR ST
Practice Address - Street 2:
Practice Address - City:HARPERS FERRY
Practice Address - State:WV
Practice Address - Zip Code:25425-3641
Practice Address - Country:US
Practice Address - Phone:304-535-6343
Practice Address - Fax:304-596-2840
Is Sole Proprietor?:No
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program