Wieczorek, Stephen M

Wieczorek, Stephen M is an sole proprietor health care provider with primary practice located at 3263 Pine Ave , Erie PA 16504-1159. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Wieczorek, Stephen M can be contacted via phone (814) 456-7862.

Contact Information

Primary practice address
3263 Pine Ave Erie PA 16504-1159
Fax: (814) 452-1803
Website:

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X SC002919L Pennsylvania

Profile Details

NPI number 1740246701
LBN Legal business name Wieczorek, Stephen M
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 26th, 2006
Last updated Jan 1st, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740246701 NPPES
Pennsylvania MEDICAID 0010471550002

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