Wisniewski, Steven John
Wisniewski, Steven John is an individual health care provider with primary practice located at 829 N Center Ave Suite 140, Gaylord MI 49735-1595. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Geriatric Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Wisniewski, Steven John can be contacted via phone (989) 731-7870.Contact Information
Primary practice address
829 N Center Ave Suite 140
Gaylord MI 49735-1595
Phone: (989) 731-7870
Fax: (989) 731-7837
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Geriatric Medicine | 207RG0300X | 430150548 | Michigan |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 4301050548 | Michigan |
Profile Details
| NPI number | 1104851658 |
|---|---|
| LBN Legal business name | Wisniewski, Steven John |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 12th, 2006 |
| Last updated | Jun 19th, 2018 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104851658 | NPPES |
| Other | 381303843 | TAX ID | |
| MEDICAID | 4619513 | TAX ID | |
| Other | 11292239 | TAX ID | |
| Other | 0F96004016 | TAX ID | |
| Other | 1101507782 | TAX ID | |
| Other | CC4805 | TAX ID |
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