Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 35043358 | OH |
NPI | 1063400232 |
---|---|
Provider Name | David M Weiner |
First Address | Mayfield Hts, OH 44124 |
Second Address | Garfield Hts, OH 44125 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2005 |
Last Update Date | 10/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0495067 | (05) | OH |
C02266 | (02) | OH |