Provider Demographics
NPI:1871553941
Name:WEINER, GEORGE P (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:P
Last Name:WEINER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9512 HARFORD RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-3120
Mailing Address - Country:US
Mailing Address - Phone:410-882-0600
Mailing Address - Fax:410-882-2133
Practice Address - Street 1:9512 HARFORD RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-3120
Practice Address - Country:US
Practice Address - Phone:410-882-0600
Practice Address - Fax:410-882-2133
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0026475207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD5584657OtherAETNA PPO
MD2103646OtherAETNA HMO
MD422514OtherBC/BS
MD2103646OtherAETNA HMO
MD422514OtherBC/BS