Provider Demographics
NPI:1326018714
Name:CONCINO, STEPHEN MICHAEL (DPM)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:MICHAEL
Last Name:CONCINO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:814 S GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3124
Mailing Address - Country:US
Mailing Address - Phone:717-845-5988
Mailing Address - Fax:717-848-2684
Practice Address - Street 1:814 S GEORGE ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3124
Practice Address - Country:US
Practice Address - Phone:717-845-5988
Practice Address - Fax:717-848-2684
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC001560L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA81778OtherMEDPLUS
PAC0101983OtherBLUE SHIELD
PAC0101983OtherBLUE SHIELD
PAT28607Medicare UPIN