Organization
EAST PENN PODIATRY ASSOC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL L STEVENS DPM (PODIATRIST)
(610) 683-5067
Entity
Organization
Contact information
Practice address
91 CONSTITUTION BLVD, KUTZTOWN, PA 19530-1736
(610) 683-5067
(610) 683-3823
Mailing address
91 CONSTITUTION BLVD, KUTZTOWN, PA 19530-1736
(610) 683-5067
(610) 683-3823
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC003061L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02551100
BLUE CROSS
—
Enumeration date
11/10/2005
Last updated
08/22/2020
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