Individual
PAUL J WIECKOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
101 PIKE ST, WEIRTON, WV 26062-3919
(304) 723-1797
(304) 723-1755
Mailing address
101 PIKE ST, WEIRTON, WV 26062-3919
(304) 723-1797
(304) 723-1755
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
259
WV
213ES0103X
Foot & Ankle Surgery Podiatrist
36003334W
OH
213ES0103X
Foot & Ankle Surgery Podiatrist
SC003459L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0099632000
—
WV
Enumeration date
07/28/2005
Last updated
07/08/2007
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