| Steven John Wisniewski, MD | |
|
829 N Center Ave, Suite 140, Gaylord, MI 49735-1595 | |
| (989) 731-7870 | |
| (989) 731-7837 |
| Full Name | Steven John Wisniewski |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Experience | 42 Years |
| Location | 829 N Center Ave, Gaylord, Michigan |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104851658 | NPI | - | NPPES |
| 381303843 | Other | TAX ID | |
| 4619513 | Medicaid | MI | |
| 11292239 | Other | CAQH PROVIDER ID | |
| 0F96004016 | Other | MI | MEDICARE PTAN |
| 1101507782 | Other | MI | BCBSM PROVIDER NUMBER |
| CC4805 | Other | MEDICARE RR PROV ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | 430150548 (Michigan) | Secondary |
| 207R00000X | Internal Medicine | 4301050548 (Michigan) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Munson Home Care | Traverse city, MI | Home health agency |
| Hospice Of Northeastern Michigan | Gaylord, MI | Hospice |
| Compassus - Northern Michigan | West branch, MI | Hospice |
| Munson Healthcare Otsego Memorial Hospital | Gaylord, MI | Hospital |
| Charlevoix Area Hospital | Charlevoix, MI | Hospital |
| Munson Healthcare Grayling Hospital | Grayling, MI | Hospital |
| Munson Healthcare Otsego Memorial Hospital Ltcu | Gaylord, MI | Nursing home |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Munson Healthcare Otsego Memorial Hospital | 8325942535 | 78 |
| Entity Name | Munson Healthcare Otsego Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164628426 PECOS PAC ID: 8325942535 Enrollment ID: O20040305000525 |
| Mailing Address | Practice Location Address |
|---|---|
| Steven John Wisniewski, MD 271 Mccoy Rd W, Gaylord, MI 49735-8253 Ph: (989) 731-7708 | Steven John Wisniewski, MD 829 N Center Ave, Suite 140, Gaylord, MI 49735-1595 Ph: (989) 731-7870 |
Justin Frank Klamerus, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 701 N Otsego Ave, Gaylord, MI 49735 Phone: 989-731-7760 | |
Dr. Changxin Li, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 829 N Center Ave, Suite 140, Gaylord, MI 49735 Phone: 989-731-7870 Fax: 989-731-7837 | |
Dr. Rosanne Beth Freeman Paz, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 508 Random Ln, Gaylord, MI 49735 Phone: 989-732-3508 Fax: 989-731-5260 | |
Matthew A Mazur, D.O. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 829 N Center Ave, Suite 140, Gaylord, MI 49735 Phone: 989-731-7870 Fax: 989-731-7837 | |
Dr. George Abraham, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 825 N Center Ave, Gaylord, MI 49735 Phone: 989-731-2100 | |
Dr. Kristine E. Bobish, D.O. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 101e Mitchell St, Gaylord, MI 49735 Phone: 989-448-7002 Fax: 989-448-2999 |