Provider Demographics
NPI:1235852047
Name:STEPP, JACOB M (PHARMD)
Entity Type:Individual
Prefix:
First Name:JACOB
Middle Name:M
Last Name:STEPP
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1280 WALTON BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307-6900
Mailing Address - Country:US
Mailing Address - Phone:248-608-0643
Mailing Address - Fax:248-608-0696
Practice Address - Street 1:1280 WALTON BLVD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-6900
Practice Address - Country:US
Practice Address - Phone:248-608-0643
Practice Address - Fax:248-608-0696
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302414726183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist