Provider Demographics
NPI:1013997220
Name:WOLFINGTON, STEVEN LEE (DPM)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:LEE
Last Name:WOLFINGTON
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 1:1714 N 8TH ST
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-2734
Mailing Address - Country:US
Mailing Address - Phone:920-457-6104
Mailing Address - Fax:920-457-6105
Practice Address - Street 1:1714 N 8TH ST
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-2734
Practice Address - Country:US
Practice Address - Phone:920-457-6104
Practice Address - Fax:920-457-6105
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2011-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI634-025213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43265900Medicaid
WIT91952Medicare UPIN
WI86649Medicare ID - Type Unspecified