Provider Demographics
NPI:1427478130
Name:WEINER, SCOTT (DO)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:WEINER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 FRANKLIN HEALTH CMNS
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04938-6144
Mailing Address - Country:US
Mailing Address - Phone:207-661-5453
Mailing Address - Fax:
Practice Address - Street 1:111 FRANKLIN HEALTH CMNS
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:ME
Practice Address - Zip Code:04938-6144
Practice Address - Country:US
Practice Address - Phone:207-661-5453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-21
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH87330207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery