Healthcare Provider Details

I. General information

NPI: 1982751236
Provider Name (Legal Business Name): DAVID HARRIS WEINSTEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 06/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5669 PEACHTREE DUNWOODY RD NE SUITE 210
ATLANTA GA
30342-1786
US

IV. Provider business mailing address

5669 PEACHTREE DUNWOODY RD NE SUITE 210
ATLANTA GA
30342-1786
US

V. Phone/Fax

Practice location:
  • Phone: 404-255-4333
  • Fax: 404-255-9691
Mailing address:
  • Phone: 404-255-4333
  • Fax: 404-255-9691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number053966
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: