Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 01068076A | IN |
N | 208200000X | Surgeon | 01068076A | IN |
N | 208600000X | Surgeon | 01068076A | IN |
N | 208200000X | Surgeon | 4301080113 | MI |
N | 208600000X | Surgeon | 4301080113 | MI |
Y | 2086S0129X | Vascular Surgeon | 01068076A | IN |
NPI | 1164637070 |
---|---|
Provider Name | Jeffrey Weinberger |
First Address | Indianapolis, IN 46250-2805 |
Second Address | Indianapolis, IN 46250-2693 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2007 |
Last Update Date | 05/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P01198088 | RR MEDICARE PTAN (01) | IN |