Individual
ANTONIUS SU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
595 N DOBSON RD, SUITE D-71, CHANDLER, AZ 85224-4226
(480) 963-9000
(480) 963-0375
Mailing address
595 N DOBSON RD, SUITE D-71, CHANDLER, AZ 85224-4226
(480) 963-9000
(480) 963-0375
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0496
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139148
—
AZ
01
—
1Z2392
HEALTHNET
AZ
01
—
AZ0193890
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
10/13/2005
Last updated
02/03/2021
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