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General NPI Number Information
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NPI Number | 1184616047
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Entity Type | Individual
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Provider Name | MARK J WEINER M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/17/2005
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 100 RIVER POINTE PKWY
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City | CANTON
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State | GA
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Zip | 30114-2865
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Country | US
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Telephone | 770-720-4041
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Fax | 770-479-4857
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Provider Business Mailing Address
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Address Line | 800 MOUNT VERNON HWY NE STE 120
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City | ATLANTA
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State | GA
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Zip | 30328-4293
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Country | US
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Telephone | 770-720-4041
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Fax | 770-479-4857
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 33748
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License Number State | GA
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