MEDICARE: MARC WEINBERG MD PERSONAL HEALTHCARE LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician

General Provider Information

NPI Number	:	1457509556
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARC WEINBERG MD PERSONAL HEALTHCARE LTD

Provider Business Mailing Address
First Line	:	82 TALBOT WAY
Second Line	:
City	:	SEEKONK
State	:	MA
Zip	:	02771-2802
Country	:	US
Telephone Number	:	508-399-8332
Fax Number	:	615-234-2460

Provider Business Practice Location Address
First Line	:	1 RANDALL SQ STE 304
Second Line	:
City	:	PROVIDENCE
State	:	RI
Zip	:	02904-2773
Country	:	US
Telephone Number	:	401-228-3000
Fax Number	:	401-649-4222

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MARC S WEINBERG
Credential	:	M.D.
Telephone Number	:	401-228-4444

Provider Enumeration Date	:	09/03/2008
Last Update Date	:	08/05/2019

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