Provider Demographics
NPI:1225020266
Name:WIENER, STEVEN NEAL (DPM)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:NEAL
Last Name:WIENER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 STONER AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-5698
Mailing Address - Country:US
Mailing Address - Phone:410-848-6800
Mailing Address - Fax:410-857-4227
Practice Address - Street 1:295 STONER AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5698
Practice Address - Country:US
Practice Address - Phone:410-848-6800
Practice Address - Fax:410-857-4227
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2009-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00437213E00000X
PASC001738L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD307LOtherMEDICARE GROUP
10003490001OtherMEDICARE DME
MD405429600Medicaid
MDJ239OtherBLUE CHOICE AND FEDERAL BLUE CROSS
MD405FOtherMEDICARE INDIVIDUAL
MD241AALOtherCAREFIRSTBLUE CROSS/BLUE SHIELD
MD602348700Medicaid
MD200224590OtherTAX ID
MD241AALOtherCAREFIRSTBLUE CROSS/BLUE SHIELD