Healthcare Provider Details

I. General information

NPI: 1659457380
Provider Name (Legal Business Name): NANCY CANTER WEINER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

980 JOHNSON FERRY RD STE 490
ATLANTA GA
30342-1607
US

IV. Provider business mailing address

980 JOHNSON FY RD NE STE 490
ATLANTA GA
30342-1607
US

V. Phone/Fax

Practice location:
  • Phone: 404-350-8941
  • Fax: 404-355-1827
Mailing address:
  • Phone: 404-350-8941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberD33749
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberD33749
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: