Basic Information
| Provider Information | |||||||||
| NPI: | 1780874255 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WEHMEYER | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3988 | ||||||||
| Address2: | 1239 E MAIN STREET | ||||||||
| City: | CARBONDALE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 629023988 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6184575200 | ||||||||
| FaxNumber: | 6185290568 | ||||||||
| Practice Location | |||||||||
| Address1: | 275 W 12TH ST | ||||||||
| Address2: | |||||||||
| City: | PERU | ||||||||
| State: | IN | ||||||||
| PostalCode: | 469701638 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7654728000 | ||||||||
| FaxNumber: | 2604792917 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/31/2007 | ||||||||
| LastUpdateDate: | 02/14/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 036.124941 | IL | Y | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | MD33042 | SC | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 01073571A | IN | N | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 201230820 | 05 | IN | MEDICAID |