Provider Demographics
NPI:1447329776
Name:WINELAND, STEVEN J (OD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:J
Last Name:WINELAND
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:731 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-4644
Mailing Address - Country:US
Mailing Address - Phone:920-452-3127
Mailing Address - Fax:920-457-6659
Practice Address - Street 1:731 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-4644
Practice Address - Country:US
Practice Address - Phone:920-452-3127
Practice Address - Fax:920-457-6659
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1609152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38500800Medicaid
WI0750430001Medicare NSC
WI38500800Medicaid
WIT63164Medicare UPIN