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General NPI Number Information
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NPI Number | 1114264637
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Entity Type | Individual
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Provider Name | CHRISTOPHER CHASE SUREK D.O.
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Gender | Male
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Dates
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Enumeration Date | 01/04/2013
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 9500 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44195-8500
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Country | US
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Telephone | 216-296-3715
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Fax |
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Provider Business Mailing Address
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Address Line | 8706 W 132ND PL
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City | OVERLAND PARK
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State | KS
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Zip | 66213-4625
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Country | US
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Telephone | 916-827-3387
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 9407635
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 012856
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License Number State | OH
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