Individual
CHRISTOPHER MICHAEL DIEFENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
107 E OAK AVE, FLAGSTAFF, AZ 86001
(928) 779-7880
(928) 913-8801
Mailing address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 213-6235
(928) 213-6292
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
53879
AZ
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
53879
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13767358
CAQH
—
Enumeration date
05/01/2011
Last updated
07/21/2022
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