Provider Demographics
NPI:1215181532
Name:SUYKERBUYK, CHRISTOPHER ANDREAS (DPM)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ANDREAS
Last Name:SUYKERBUYK
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9058
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85214-9058
Mailing Address - Country:US
Mailing Address - Phone:480-633-7944
Mailing Address - Fax:480-633-0255
Practice Address - Street 1:2919 S ELLSWORTH RD STE 124
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85212-2167
Practice Address - Country:US
Practice Address - Phone:480-633-7944
Practice Address - Fax:480-633-0255
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-13
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0728213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery