MEDICARE: IRA WEINER DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	9205	NV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	480029440	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	10979	OTHER	NV	NEVADACARE
3	1078320	OTHER		UNITED HC
4	860864650	OTHER		TAX ID
5	002102788	OTHER	NV	NV HEALTH SOLUTIONS
7	8608645001	OTHER		CULINARY
8	10339	OTHER		PACIFICARE
9	002102788	OTHER	NV	NV KIDS
10	0608272	OTHER		AETNA
11	860864650	OTHER		UFCW

General Provider Information

NPI Number	:	1326127408
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IRA WEINER DPM

Provider Business Mailing Address
First Line	:	PO BOX 93423
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89193-3423
Country	:	US
Telephone Number	:	702-389-5360
Fax Number	:	702-389-5360

Provider Business Practice Location Address
First Line	:	9260 W SUNSET RD STE 201
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-4903
Country	:	US
Telephone Number	:	702-389-5360
Fax Number	:	702-829-8420

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	11/28/2017

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Directions to “ IRA WEINER DPM” Practice Location

Language	Start Address	Practice Location

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