Provider Demographics
NPI:1083893374
Name:LARRY STEPT MD PC
Entity Type:Organization
Organization Name:LARRY STEPT MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:STEPT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-228-3401
Mailing Address - Street 1:1480 JEFFERSON AVE
Mailing Address - Street 2:PO BOX 28
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-2126
Mailing Address - Country:US
Mailing Address - Phone:724-228-3401
Mailing Address - Fax:724-228-7040
Practice Address - Street 1:401 E MURPHY AVE
Practice Address - Street 2:
Practice Address - City:CONNELLSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15425-2724
Practice Address - Country:US
Practice Address - Phone:724-628-1500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-02
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD041539-L208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA066699Medicare PIN
PAE65453Medicare UPIN