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General NPI Number Information
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NPI Number | 1922333996
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Entity Type | Individual
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Provider Name | SCOTT WIENER M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/08/2009
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 8777 W FOREST HOME AVE
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City | GREENFIELD
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State | WI
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Zip | 53228-3421
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Country | US
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Telephone | 206-785-1015
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Fax | 206-785-1023
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Provider Business Mailing Address
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Address Line | 321 BURNETT AVE S FL 2
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City | RENTON
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State | WA
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Zip | 98057-2558
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Country | US
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Telephone | 206-785-1015
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Fax | 206-785-1023
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 69093-20
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License Number State | WI
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