Provider Demographics
NPI:1962557082
Name:L P WEAN MD PC
Entity type:Organization
Organization Name:L P WEAN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:P
Authorized Official - Last Name:WEAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-891-9640
Mailing Address - Street 1:1098 W BALTIMORE PIKE
Mailing Address - Street 2:RMH OPP STE 3304
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-5139
Mailing Address - Country:US
Mailing Address - Phone:610-891-9640
Mailing Address - Fax:610-891-9644
Practice Address - Street 1:1098 W BALTIMORE PIKE
Practice Address - Street 2:RMH OPP STE 3304
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5139
Practice Address - Country:US
Practice Address - Phone:610-891-9640
Practice Address - Fax:610-891-9644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD025249E261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care