Healthcare Provider Details

I. General information

NPI: 1144961129
Provider Name (Legal Business Name): NOLAN WEINSTEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 W THOMAS RD
PHOENIX AZ
85013-4496
US

IV. Provider business mailing address

PO BOX 41150
MESA AZ
85274-1150
US

V. Phone/Fax

Practice location:
  • Phone: 602-406-3000
  • Fax:
Mailing address:
  • Phone: 480-425-2160
  • Fax: 480-839-4727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number79709
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: