Provider Demographics
NPI:1992706006
Name:SUTTON, ANN THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:THOMAS
Last Name:SUTTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CAROLE
Other - Middle Name:ANN
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 751069
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1069
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:600 MOYE BLVD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-4300
Practice Address - Country:US
Practice Address - Phone:252-744-2803
Practice Address - Fax:252-744-3616
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9701611207ZC0500X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1233HOtherBCBS OF NC
P00181918OtherRAILROAD MEDICARE
NC891233HMedicaid
NC1233HOtherBCBSNC
NC1233HOtherBCBSNC
P00181918OtherRAILROAD MEDICARE
NC2274865CMedicare PIN