Healthcare Provider Details

I. General information

NPI: 1043328305
Provider Name (Legal Business Name): DAVID LEE WEINSTEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 08/10/2021
Certification Date: 08/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3023 N BALLAS RD STE 440D
SAINT LOUIS MO
63131-2363
US

IV. Provider business mailing address

3023 N BALLAS RD STE 440D
SAINT LOUIS MO
63131-2363
US

V. Phone/Fax

Practice location:
  • Phone: 314-432-8181
  • Fax: 314-432-0090
Mailing address:
  • Phone: 314-432-8181
  • Fax: 314-432-0090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number36821
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: