Provider Demographics
NPI:1083694863
Name:STEPP, MARK E (OD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:E
Last Name:STEPP
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 VINCENT DR
Mailing Address - Street 2:
Mailing Address - City:WINDBER
Mailing Address - State:PA
Mailing Address - Zip Code:15963-1573
Mailing Address - Country:US
Mailing Address - Phone:814-467-9062
Mailing Address - Fax:814-266-5368
Practice Address - Street 1:810 VINCENT DR
Practice Address - Street 2:
Practice Address - City:WINDBER
Practice Address - State:PA
Practice Address - Zip Code:15963-1573
Practice Address - Country:US
Practice Address - Phone:814-467-9062
Practice Address - Fax:814-266-5368
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG-000068152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017285970004Medicaid
PA187938OtherBLUECROSSBLUESHIELD
PA0017285970005Medicaid
PA0017285970006Medicaid
PA0017285970006Medicaid
PA0017285970004Medicaid
PA0017285970004Medicaid