Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | MD014359E | PA |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | MD 014359E | PA |
NPI | 1093716201 |
---|---|
Provider Name | Dr. Stuart Weiner |
First Address | Philadelphia, PA 19107-4420 |
Second Address | Philadelphia, PA 19107-4420 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2005 |
Last Update Date | 23/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000760034 | (05) | PA |
0007600340023 | (05) | PA |
1373307 | (05) | NJ |
C31714 | (02) |