Healthcare Provider Details

I. General information

NPI: 1063482289
Provider Name (Legal Business Name): JOEL W WINER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 03/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228 SAINT CHARLES WAY STE 300
YORK PA
17402-4661
US

IV. Provider business mailing address

1803 MOUNT ROSE AVE SUITE B3
YORK PA
17403-3026
US

V. Phone/Fax

Practice location:
  • Phone: 717-812-5400
  • Fax: 717-741-3598
Mailing address:
  • Phone: 717-851-1405
  • Fax: 717-741-3598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberMD040236L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: