Provider Demographics
NPI:1225115512
Name:STESS, MARC A (DPM)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:A
Last Name:STESS
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:539 HARKLE RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-4782
Mailing Address - Country:US
Mailing Address - Phone:505-988-8863
Mailing Address - Fax:505-988-5940
Practice Address - Street 1:539 HARKLE RD
Practice Address - Street 2:SUITE C
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4782
Practice Address - Country:US
Practice Address - Phone:505-988-8863
Practice Address - Fax:505-988-5940
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM124213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T41101Medicare UPIN