Provider Demographics
NPI:1417038365
Name:SLUITER, ERIC EUGENE (DPM)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:EUGENE
Last Name:SLUITER
Suffix:
Gender:
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:483 W SEED FARM RD
Mailing Address - Street 2:
Mailing Address - City:SACATON
Mailing Address - State:AZ
Mailing Address - Zip Code:85147-5000
Mailing Address - Country:US
Mailing Address - Phone:602-528-1258
Mailing Address - Fax:602-528-1258
Practice Address - Street 1:483 W SEED FARM RD
Practice Address - Street 2:
Practice Address - City:SACATON
Practice Address - State:AZ
Practice Address - Zip Code:85147-5000
Practice Address - Country:US
Practice Address - Phone:602-528-1258
Practice Address - Fax:602-528-1258
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ00822213ES0103X
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