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Individual

DR. PAUL PHILLIP STEPANCZUK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1650 45TH AVE, MUNSTER, IN 46321-3962
(219) 836-9488
(219) 836-9497
Mailing address
1650 45TH AVE, MUNSTER, IN 46321-3962
(219) 836-9488
(219) 836-9497

Taxonomy

Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
07000758
IN
213ES0131X
Foot Surgery Podiatrist
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6002117465
BLUE CROSS BL SHIELD
IN
01
90000152
BLUE CROSS BL SHIELD
IL
Enumeration date
09/08/2006
Last updated
07/08/2007
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