Healthcare Provider Details

I. General information

NPI: 1487787354
Provider Name (Legal Business Name): STEP BY STEP PEDIATRICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6920 PARKDALE PL SUITE 109
INDIANAPOLIS IN
46254-5612
US

IV. Provider business mailing address

6920 PARKDALE PL SUITE 109
INDIANAPOLIS IN
46254-5612
US

V. Phone/Fax

Practice location:
  • Phone: 317-328-6802
  • Fax: 317-328-6840
Mailing address:
  • Phone: 317-328-6802
  • Fax: 317-328-6840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number StateIN

VIII. Authorized Official

Name: MRS. DEBBIE N. HOFFMAN
Title or Position: OFFICE MANAGER
Credential:
Phone: 317-328-6802