Healthcare Provider Details

I. General information

NPI: 1174506810
Provider Name (Legal Business Name): ROBERT ALAN WEINER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2005
Last Update Date: 01/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3120 HIGHLAND RD SUITE 201
HERMITAGE PA
16148-4512
US

IV. Provider business mailing address

PO BOX 1032
HERMITAGE PA
16148-0032
US

V. Phone/Fax

Practice location:
  • Phone: 724-342-1833
  • Fax: 724-342-3391
Mailing address:
  • Phone: 706-660-8505
  • Fax: 706-660-9390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberMD035652E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: