Provider Demographics
NPI:1750381299
Name:BOC, STEVEN F (DPM)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:F
Last Name:BOC
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:235 N BROAD ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-1511
Mailing Address - Country:US
Mailing Address - Phone:215-568-3510
Mailing Address - Fax:215-568-3529
Practice Address - Street 1:235 N BROAD ST
Practice Address - Street 2:SUITE 300
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-1511
Practice Address - Country:US
Practice Address - Phone:215-568-3510
Practice Address - Fax:215-568-3529
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-27
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002554-L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0978058Medicaid
PA153969Medicare ID - Type Unspecified
PA0978058Medicaid