Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 29683 | CO |
NPI | 1003845249 |
---|---|
Provider Name | Gareth R Weiner |
First Address | Lakewood, CO 80227-5117 |
Second Address | Thornton, CO 80229-2050 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2006 |
Last Update Date | 09/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01296839 | (05) | CO |
100009339 | RAILROAD MEDICARE (01) | CO |
E19618 | (02) | CO |