MEDICARE: DR. STEPHEN C. MURPHY D.P.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0131X	Foot Surgery Podiatrist	016004652	IL
2	213E00000X	Podiatrist	016004652	IL
3	213ES0000X	Sports Medicine Podiatrist	016004652	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	480025958	OTHER	RR MCR
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	01622732	OTHER	BLUE CROSS

General Provider Information

NPI Number	:	1174590178
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN C. MURPHY D.P.M.

Provider Business Mailing Address
First Line	:	2817 NEW PINERY RD
Second Line	:	PO BOX 387
City	:	PORTAGE
State	:	WI
Zip	:	53901-0387
Country	:	US
Telephone Number	:	608-742-4131
Fax Number	:	608-745-6393

Provider Business Practice Location Address
First Line	:	2817 NEW PINERY RD
Second Line	:
City	:	PORTAGE
State	:	WI
Zip	:	53901-0387
Country	:	US
Telephone Number	:	608-742-4131
Fax Number	:	608-745-6393

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	01/31/2012

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Directions to “ DR. STEPHEN C. MURPHY D.P.M.” Practice Location

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