Basic Information
| Provider Information | |||||||||
| NPI: | 1215181532 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SUYKERBUYK | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | ANDREAS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DPM | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 9058 | ||||||||
| Address2: | |||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852149058 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4806337944 | ||||||||
| FaxNumber: | 4806330255 | ||||||||
| Practice Location | |||||||||
| Address1: | 2919 S ELLSWORTH RD STE 124 | ||||||||
| Address2: | |||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852122167 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4806337944 | ||||||||
| FaxNumber: | 4806330255 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/13/2008 | ||||||||
| LastUpdateDate: | 10/18/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213ES0103X | 0728 | AZ | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery |
No ID Information.