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General NPI Number Information
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NPI Number | 1780788190
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Entity Type | Individual
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Provider Name | PAUL PHILLIP STEPANCZUK DPM
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Gender | Male
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Dates
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Enumeration Date | 09/08/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1650 45TH AVE
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City | MUNSTER
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State | IN
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Zip | 46321-3962
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Country | US
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Telephone | 219-836-9488
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Fax | 219-836-9497
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Provider Business Mailing Address
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Address Line | 1650 45TH AVE
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City | MUNSTER
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State | IN
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Zip | 46321-3962
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Country | US
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Telephone | 219-836-9488
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Fax | 219-836-9497
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 07000758
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number |
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License Number State | IL
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