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Individual

STEVAN J ANSELMI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
103 WEST AVE, WELLSBORO, PA 16901-1358
(570) 724-5297
(570) 724-8793
Mailing address
103 WEST AVE, WELLSBORO, PA 16901-1358
(570) 724-5297
(570) 724-8793

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC001853L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
442480314
TRAVELERS MEDICARE
PA
Enumeration date
09/23/2005
Last updated
10/12/2007
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