Healthcare Provider Details

I. General information

NPI: 1306822804
Provider Name (Legal Business Name): ROBERT MICHAEL WEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/16/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

719 GREEN VALLEY ROAD SUITE 201
GREENSBORO NC
27608-7025
US

IV. Provider business mailing address

719 GREEN VALLEY ROAD SUITE 201
GREENSBORO NC
27608-7025
US

V. Phone/Fax

Practice location:
  • Phone: 336-378-1110
  • Fax: 336-378-9986
Mailing address:
  • Phone: 336-378-1110
  • Fax: 336-378-9986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number22645
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: