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General NPI Number Information
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NPI Number | 1780874487
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Entity Type | Individual
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Provider Name | JUSTIN B WEINER MD
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Gender | Male
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Dates
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Enumeration Date | 07/29/2007
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Last Update Date | 01/25/2022
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Provider Practice Location Address
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Address Line | 765 N HAMILTON RD SUITE 120
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City | GAHANNA
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State | OH
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Zip | 43230-8703
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Country | US
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Telephone | 614-533-5500
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Fax | 614-533-5059
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Provider Business Mailing Address
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Address Line | 5350 FRANTZ RD
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City | DUBLIN
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State | OH
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Zip | 43016-4259
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Country | US
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Telephone |
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Fax |
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 35.121922
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 35.121922
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License Number State | OH
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