Provider Demographics
NPI:1093170573
Name:WEINTRAUB, BRUCE DALE (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:DALE
Last Name:WEINTRAUB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9714 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 1114
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3773
Mailing Address - Country:US
Mailing Address - Phone:301-838-1935
Mailing Address - Fax:301-762-6287
Practice Address - Street 1:9714 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 1114
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3773
Practice Address - Country:US
Practice Address - Phone:301-838-1935
Practice Address - Fax:301-762-6287
Is Sole Proprietor?:No
Enumeration Date:2015-12-28
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0034879207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism