Provider Demographics
NPI:1962405571
Name:WEINSTEIN, RAYMOND S (MD)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:S
Last Name:WEINSTEIN
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 1:13004 ADERMAN CT
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-3344
Mailing Address - Country:US
Mailing Address - Phone:703-491-1779
Mailing Address - Fax:
Practice Address - Street 1:10900 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-2201
Practice Address - Country:US
Practice Address - Phone:703-993-4770
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101049484207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine