| Dr Ralph Marc Sutherlin, DO | |
|
622 W College Ave Ste 2, St Maries, ID 83861-1822 | |
| (208) 568-7800 | |
| (877) 902-7131 |
| Full Name | Dr Ralph Marc Sutherlin |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Experience | 28 Years |
| Location | 622 W College Ave Ste 2, St Maries, Idaho |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245291772 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2083P0500X | Preventive Medicine - Preventive Medicine/occupational Environmental Medicine | O-264 (Idaho) | Secondary |
| 207Q00000X | Family Medicine | O-264 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Benewah Community Hospital | St maries, ID | Hospital |
| Northwest Specialty Hospital | Post falls, ID | Hospital |
| Kootenai Health | Coeur d'alene, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| North Idaho Day Surgery Llc | 0840101218 | 87 |
| Syringa Health And Wellness Llc | 5395124622 | 3 |
| Entity Name | Benewah Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1336135136 PECOS PAC ID: 6709878622 Enrollment ID: O20040331001566 |
| Entity Name | Syringa Health And Wellness Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588309900 PECOS PAC ID: 5395124622 Enrollment ID: O20220616002199 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Ralph Marc Sutherlin, DO 1593 E Polston Ave, Post Falls, ID 83854-5326 Ph: (208) 262-2498 | Dr Ralph Marc Sutherlin, DO 622 W College Ave Ste 2, St Maries, ID 83861-1822 Ph: (208) 568-7800 |
Karen D Libsch, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 229 S 8th St, St Maries, ID 83861 Phone: 208-245-2591 Fax: 208-245-5246 |