Healthcare Provider Details

I. General information

NPI: 1780626937
Provider Name (Legal Business Name): ERIC D WEINER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 CANE CREEK RD
FLETCHER NC
28732-9707
US

IV. Provider business mailing address

12 CANE CREEK RD
FLETCHER NC
28732-9707
US

V. Phone/Fax

Practice location:
  • Phone: 828-687-7722
  • Fax: 828-687-7174
Mailing address:
  • Phone: 828-687-7722
  • Fax: 828-687-7174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2006-00696
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: