Provider Demographics
NPI:1417038365
Name:SLUITER, ERIC EUGENE (DPM)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:EUGENE
Last Name:SLUITER
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 1:7828 WAKELEY PLZ
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-3650
Mailing Address - Country:US
Mailing Address - Phone:402-926-2600
Mailing Address - Fax:402-926-2605
Practice Address - Street 1:7828 WAKELEY PLZ
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-3650
Practice Address - Country:US
Practice Address - Phone:402-926-2600
Practice Address - Fax:402-926-2605
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE291213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025113300Medicaid
NE5130280001Medicare NSC
NE277628Medicare ID - Type Unspecified
NEU95930Medicare UPIN