Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 63942 | AZ |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | D0050832 | MD |
NPI | 1174553440 |
---|---|
Provider Name | Carl P Weiner |
First Address | Phoenix, AZ 85067-3269 |
Second Address | Phoenix, AZ 85013-4295 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 26/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
349451900 | (05) | MD |
A02240 | (02) | |
LT 35 / 543699-01 | BC / BS OF MD (01) | MD |
S186 / 0067 | BLUECHOICE (01) | MD |