Healthcare Provider Details

I. General information

NPI: 1457509556
Provider Name (Legal Business Name): MARC WEINBERG MD PERSONAL HEALTHCARE LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2008
Last Update Date: 08/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 RANDALL SQ STE 304
PROVIDENCE RI
02904-2773
US

IV. Provider business mailing address

82 TALBOT WAY
SEEKONK MA
02771-2802
US

V. Phone/Fax

Practice location:
  • Phone: 401-228-3000
  • Fax: 401-649-4222
Mailing address:
  • Phone: 508-399-8332
  • Fax: 615-234-2460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MARC S WEINBERG
Title or Position: PRESIDENT
Credential: M.D.
Phone: 401-228-4444