Healthcare Provider Details

I. General information

NPI: 1104862598
Provider Name (Legal Business Name): PETER J WEINA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 DEWITT LOOP
FORT BELVOIR VA
22060-5285
US

IV. Provider business mailing address

8340 KENWOOD AVE
SPRINGFIELD VA
22152-2825
US

V. Phone/Fax

Practice location:
  • Phone: 703-268-8583
  • Fax:
Mailing address:
  • Phone: 703-569-2719
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number10127
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: