MARK ERIN SUTHERLAND (NPI# 1164475794) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164475794 |
| Entity Type | Individual |
| Full Name | MARK ERIN SUTHERLAND |
| Credential | DO |
| Practice Address |
149 North St Waterville ME 04901-4974 |
| Practice Telephone | 2078615101 |
| Practice Fax Number | 2078724341 |
| Mailing Telephone | 2078615101 |
| Mailing Fax Number | 2078724341 |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2019-05-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204D00000X | Neuromusculoskeletal Medicine & OMM | 2025 | ME | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 2025 | ME | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 0530213 | KS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | 100457760B | 05 | |
| ME | 432706399 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346286143 | Mark Herbert Sutherland | Physician Assistant | 799 Lumsden Rd., Brandon, FL 33511 | 2006-06-21 |
| 1700862893 | Mark V Sutherland | Family Medicine | 43 Smith Road, Nhcne, Newport, RI 02841 | 2005-12-20 |
| 1659799286 | Mark Edward Sutherland | Emergency Medicine | 22 S Greene St, Room N3e09, Baltimore, MD 21201-1544 | 2014-04-01 |
| 1659462497 | Mark John Sutherland | Pharmacist | 921 Ne 13th St, Oklahoma City, OK 73104-5007 | 2006-09-27 |
| 1023057353 | Mark Edward Sutherland | Surgery | 2717 Summerhill Rd, Texarkana, TX 75503-3957 | 2006-06-05 |
| 1578554606 | Mark Joseph Sutherland | Anesthesiology | 2131 S 17th St, Wilmington, NC 28401-7407 | 2005-10-28 |
| Street Address |
149 NORTH ST |
| City | WATERVILLE |
| State | ME |
| Zip Code | 04901-4974 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083691869 | Robin M Wood | Nuclear Medicine | 149 North St, Waterville, ME 04901-4974 | 2005-12-22 |
| 1588289961 | Kellee Gorgone | Nurse Practitioner | 149 North St, Waterville, ME 04901-4974 | 2020-06-11 |
| 1962027656 | Thomas Pentzer | Student in an Organized Health Care Education/Training Program | 149 North St, Waterville, ME 04901-4974 | 2020-06-09 |
| 1437774122 | Anita Nwanna-nzewunwa | Student in an Organized Health Care Education/Training Program | 149 North St, Waterville, ME 04901-4974 | 2020-06-09 |
| 1487279162 | Jesse Leeds | Student in an Organized Health Care Education/Training Program | 149 North St, Waterville, ME 04901-4974 | 2020-06-09 |
| 1093366239 | Danielle Rice | Nurse Practitioner | 149 North St, Waterville, ME 04901-4974 | 2019-09-27 |
| 1528627080 | Lisa Smith | Student in an Organized Health Care Education/Training Program | 149 North St, Waterville, ME 04901-4974 | 2019-06-10 |
| 1215596762 | Rose Knudsen | Student in an Organized Health Care Education/Training Program | 149 North St, Waterville, ME 04901-4974 | 2019-06-09 |
| 1053970509 | Lara Householder | Student in an Organized Health Care Education/Training Program | 149 North St, Waterville, ME 04901-4974 | 2019-06-09 |
| 1033694807 | Elizabeth Harwood | Nurse Practitioner | 149 North St, Waterville, ME 04901-4974 | 2018-09-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093325649 | Orthopedic Physical Therapy | Physical Therapist | Orthopedic Physical Therapy, 234 College Ave, Waterville, ME 04901 | 2020-08-07 |
| 1790328771 | Elizabeth Saucier | Counselor | Discovery House 40 Airport Rd, Waterville, ME 04901 | 2019-10-23 |
| 1780233445 | Amy Marie Tardy | Counselor | 325 Kmd, Building D - Unit 4, 325 Kmd - Building D -- Unit 4, Waterville, ME 04901 | 2019-09-05 |
| 1457905911 | Waterville Audiology PC | Audiologist-Hearing Aid Fitter | 124 Silver Street, Waterville, ME 04901 | 2019-08-01 |
| 1629537048 | Samantha Sobel | Behavioral Analyst | 2 Seton Center Dr, Waterville, ME 04901 | 2019-03-15 |
| 1366916025 | Waterville Pharmacy | Pharmacy | 20 Concourse W, Waterville, ME 04901 | 2019-01-16 |
| 1699243733 | Thomas James Demers | Counselor | Discovery House, 40 Airport Road, Waterville, ME 04901 | 2018-11-07 |
| 1851892442 | Alishia M Austin | Counselor | Discovery House Ctc Waterville 40 Airport Rd, Waterville, ME 04901 | 2018-02-28 |
| 1336671056 | Douglas Joseph Dicola | Family Medicine | Mainegeneral Medical Center, 149 North St, Waterville, ME 04901 | 2017-03-31 |
| 1134660020 | Waterville Medical Supplies | Durable Medical Equipment & Medical Supplies | 325 Waterville Commons Drive, Waterville, ME 04901 | 2017-03-13 |
| Find all providers in zip 04901 | ||||
| Taxonomy Code | 204D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neuromusculoskeletal Medicine & OMM |
| The Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician directs special attention to the neuromusculoskeletal system and its interaction with other body systems. Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine, and integrates each of these into the management of pediatric, adolescent, adult, and geriatric patients. |
| Notes: Source: American Osteopathic Association, 2017 [7/1/2017: added definition] - Additional Resources: American Osteopathic Board of Neuromusculoskeletal Medicine, 2017, http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417336603 | William Cochran Mcdougall Iv | Neuromusculoskeletal Medicine & OMM | 149 North St, Waterville, ME 04901-4974 | 2015-05-21 |
| 1831537109 | Samuel Madore | Neuromusculoskeletal Medicine & OMM | 149 North St, Waterville, ME 04901-4974 | 2013-06-10 |
| 1528175312 | Kiran A Mangalam | Neuromusculoskeletal Medicine & OMM | 149 North St, Waterville, ME 04901-4974 | 2006-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417428848 | David D Keller Do PC | Neuromusculoskeletal Medicine & OMM | 195 Fore River Pkwy Ste 470, Portland, ME 04102-2787 | 2018-12-11 |
| 1659715738 | Maine Osteopathic Medicine, LLC | Neuromusculoskeletal Medicine & OMM | 146 Ocean St, Suite 2, South Portland, ME 04106-3664 | 2013-04-19 |
| 1114161874 | Timothy Christopher Kulikowski | Neuromusculoskeletal Medicine & OMM | 915 Union St Ste 4, Bangor, ME 04401-8603 | 2009-04-26 |
| 1720242357 | Daniel S Gibbons | Neuromusculoskeletal Medicine & OMM | 23 Durham Rd Ste 101, Freeport, ME 04032-6796 | 2008-07-14 |
| 1285896514 | Jennifer Lee Lakis | Neuromusculoskeletal Medicine & OMM | 14 Maine St # 14, Brunswick, ME 04011-2049 | 2008-06-27 |
| 1003006271 | Karen M Benezra | Neuromusculoskeletal Medicine & OMM | 62 Portland Rd Ste 21, Kennebunk, ME 04043-6650 | 2007-07-25 |
| 1508065210 | Joshua Iannetta | Neuromusculoskeletal Medicine & OMM | 632 Us Route 1, Scarborough, ME 04074-9794 | 2007-07-12 |
| 1265579015 | Bonnie Joan Sendzicki | Neuromusculoskeletal Medicine & OMM | 81 Blackguard Road, Waterford, ME 04088 | 2007-01-31 |
| 1760531180 | Christine Blake Smith | Neuromusculoskeletal Medicine & OMM | 114 Stroudwater St, Westbrook, ME 04092-4037 | 2007-01-09 |
| 1003984311 | Charles W Sullivan | Neuromusculoskeletal Medicine & OMM | 98 Second St, Hallowell, ME 04347-1368 | 2006-12-04 |
| Find all providers with the same taxonomy | ||||
| City | WATERVILLE |
| Zip Code | 04901 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.