Healthcare Provider Details

I. General information

NPI: 1366857849
Provider Name (Legal Business Name): CHRISTOPHER DAVID SUTTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2014
Last Update Date: 01/31/2024
Certification Date: 01/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 CRISANTO AVE STE B
FORT MILL SC
29715-6272
US

IV. Provider business mailing address

130 CRISANTO AVE STE B
FORT MILL SC
29715-6272
US

V. Phone/Fax

Practice location:
  • Phone: 803-548-6464
  • Fax: 803-396-8440
Mailing address:
  • Phone: 803-548-6464
  • Fax: 803-396-8440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number6893
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License NumberSC-MD85773
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberSC-MD85773
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: