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Individual

DR. STEPHEN M WIECZOREK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
3263 PINE AVE, ERIE, PA 16504-1159
(814) 456-7862
(814) 452-1803
Mailing address
3263 PINE AVE, ERIE, PA 16504-1159
(814) 456-7862
(814) 452-1803

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC002919L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0010471550002
PA
Enumeration date
04/26/2006
Last updated
01/01/2013
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