Provider Demographics
NPI:1447295431
Name:WEINTRAUB, ALAN G (MD)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:G
Last Name:WEINTRAUB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ALAN
Other - Middle Name:GERALD
Other - Last Name:WEINTRAUB
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5635 PEACHTREE PARKWAY
Mailing Address - Street 2:STE 120
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30092
Mailing Address - Country:US
Mailing Address - Phone:770-416-6428
Mailing Address - Fax:770-416-6788
Practice Address - Street 1:5635 PEACHTREE PARKWAY
Practice Address - Street 2:STE 120
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092
Practice Address - Country:US
Practice Address - Phone:770-416-6428
Practice Address - Fax:770-416-6788
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA030921208000000X, 2080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Not Answered2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics