Provider Demographics
NPI:1467496554
Name:WILHELM, STEPHEN J (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:J
Last Name:WILHELM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1927 E CARSON ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15203-1835
Mailing Address - Country:US
Mailing Address - Phone:412-381-4422
Mailing Address - Fax:412-381-8503
Practice Address - Street 1:20397 ROUTE 19
Practice Address - Street 2:
Practice Address - City:CRANBERRY TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:16066-6133
Practice Address - Country:US
Practice Address - Phone:724-742-1818
Practice Address - Fax:724-742-1823
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006755L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019097990002Medicaid
PA55908Medicare ID - Type Unspecified
PA0019097990002Medicaid