Provider Demographics
NPI:1063400232
Name:WEINER, DAVID M (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:WEINER
Suffix:
Gender:
Credentials:MD
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Mailing Address - Street 1:1450 SOM CENTER RD
Mailing Address - Street 2:25
Mailing Address - City:MAYFIELD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124
Mailing Address - Country:US
Mailing Address - Phone:440-446-1423
Mailing Address - Fax:440-446-1498
Practice Address - Street 1:12000 MCCRACKEN RD
Practice Address - Street 2:201
Practice Address - City:GARFIELD HTS
Practice Address - State:OH
Practice Address - Zip Code:44125
Practice Address - Country:US
Practice Address - Phone:216-662-5600
Practice Address - Fax:216-663-1474
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-11
Last Update Date:2025-02-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35043358208M00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0495067Medicaid
OHC02266Medicare UPIN
OH0495067Medicaid