Provider Demographics
NPI:1740552561
Name:SWEENEY, STEPHEN MICHAEL (DO)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:MICHAEL
Last Name:SWEENEY
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:5515 PEACH STREET
Mailing Address - Street 2:ATTN: MEDICAL EDUCATION
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509-2603
Mailing Address - Country:US
Mailing Address - Phone:814-868-8294
Mailing Address - Fax:814-868-2489
Practice Address - Street 1:5515 PEACH STREET
Practice Address - Street 2:ATTN: MEDICAL EDUCATION
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509-2603
Practice Address - Country:US
Practice Address - Phone:814-868-8294
Practice Address - Fax:814-868-2489
Is Sole Proprietor?:No
Enumeration Date:2012-02-09
Last Update Date:2021-06-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOT021222207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV01788OtherMEDICARE PTAN