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General NPI Number Information
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NPI Number | 1972014785
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Entity Type | Organization
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Legal Business Name | PETER L. WEINGARTEN MD PC
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Dates
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Enumeration Date | 10/19/2017
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Last Update Date | 10/19/2017
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Provider Practice Location Address
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Address Line | 1411 S POTOMAC ST STE 400
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City | AURORA
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State | CO
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Zip | 80012-4540
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Country | US
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Telephone | 303-671-2122
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Fax | 303-671-2122
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Provider Business Mailing Address
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Address Line | 1411 S POTOMAC ST STE 400
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City | AURORA
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State | CO
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Zip | 80012-4540
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Country | US
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Telephone | 303-671-2122
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Fax | 303-671-2122
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Authorized Official
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Title or Position | MEDICAL/PERSONAL ASSISTANT
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Name | MRS. GAYLA DAWN CLARK
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Credential | NCMA
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Telephone | 303-671-2122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 0022177
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License Number State | CO
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