Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | MD047020L | PA |
NPI | 1023088317 |
---|---|
Provider Name | David Weinberg |
First Address | Philadelphia, PA 19129-1302 |
Second Address | Philadelphia, PA 19111-2434 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2006 |
Last Update Date | 09/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0015242000006 | (05) | PA |
E95744 | (02) |