Healthcare Provider Details

I. General information

NPI: 1467432815
Provider Name (Legal Business Name): CHRISTOPHER S CWIK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2006
Last Update Date: 05/10/2021
Certification Date: 05/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9305 W THOMAS RD STE 125
PHOENIX AZ
85037-3328
US

IV. Provider business mailing address

9059 W. LAKE PLEASANT PKWY STE E-540
PEORLA AZ
85382
US

V. Phone/Fax

Practice location:
  • Phone: 623-388-3216
  • Fax: 623-388-4902
Mailing address:
  • Phone: 623-322-3380
  • Fax: 623-322-4399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number37360
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: