Provider Demographics
NPI:1568981397
Name:STEP AHEAD PODIATRY PLLC
Entity Type:Organization
Organization Name:STEP AHEAD PODIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:MURPHY
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:734-433-5800
Mailing Address - Street 1:350 N MAIN ST STE 240
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MI
Mailing Address - Zip Code:48118-1370
Mailing Address - Country:US
Mailing Address - Phone:734-433-5800
Mailing Address - Fax:
Practice Address - Street 1:350 N MAIN ST STE 240
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118-1370
Practice Address - Country:US
Practice Address - Phone:734-433-5800
Practice Address - Fax:734-433-5801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901001833213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI125159OtherPRIORITY HEALTH
MI3313528Medicaid
MI4858251900OtherBCBSM
MI5656449OtherAETNA