MEDICARE: DR. RICHARD DAVID WEINER DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	36002479	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619963790
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD DAVID WEINER DPM

Provider Business Mailing Address
First Line	:	1045 BEECHER XING N
Second Line	:	SUITE A
City	:	GAHANNA
State	:	OH
Zip	:	43230-4573
Country	:	US
Telephone Number	:	614-304-0019
Fax Number	:	614-304-0023

Provider Business Practice Location Address
First Line	:	3192 E LIVINGSTON AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43227-1945
Country	:	US
Telephone Number	:	614-235-2323
Fax Number	:	614-235-0092

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2005
Last Update Date	:	05/11/2017

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