Provider Demographics
NPI:1104891910
Name:WINTERS, GEORGE R III (MD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:R
Last Name:WINTERS
Suffix:III
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:PO BOX 84088
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-8488
Mailing Address - Country:US
Mailing Address - Phone:425-454-5281
Mailing Address - Fax:425-990-5261
Practice Address - Street 1:1135 116TH AVE NE
Practice Address - Street 2:SUITE 140
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-4623
Practice Address - Country:US
Practice Address - Phone:425-467-0150
Practice Address - Fax:425-990-5261
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00045792207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8859175Medicare PIN