Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | POD-000901 | AZ |
NPI | 1043694235 |
---|---|
Provider Name | Dr. Brent Weintrub |
First Address | Gilbert, AZ 85296-4206 |
Second Address | Gilbert, AZ 85296 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2015 |
Last Update Date | 15/07/2018 |