Individual
STEVEN J WISNIEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
4735 OGLETOWN STANTON RD, MAP II, SUITES 1201 & 1205, NEWARK, DE 19713-2072
(302) 733-1980
(302) 733-1986
Mailing address
200 HYGEIA DR, CCHS INC., PHYSICIAN CONTRACTING, SUITE 2502, NEWARK, DE 19713-2049
(302) 623-7362
(302) 623-7374
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
C5-0000561
DE
363AS0400X
Surgical Physician Assistant
Primary
C5-0000561
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C5-0000561
PROFESSIONAL LICENSE
DE
Enumeration date
12/04/2006
Last updated
09/11/2025
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