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Contact Information

STEPHEN A WASILEWSKI, MD
191 5TH STREET WEST
KETCHUM, ID83340
 Phone: 208-726-5207
 Fax: 208-726-8948
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for STEPHEN A WASILEWSKI · (Male)

NPI Number 1700827946
Status Active
Credentials MD
Entity Individual
Enumeration date 06/09/2006
Last updated 09/06/2012 - About 14 years ago
Sole proprietor 1 Yes
Identifiers
  • ID License # M5774
  • ID Medicaid 002717800
  • ID Other P01032143 MCRR
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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