Provider Demographics
NPI:1114023363
Name:WEINAR, MARVIN A (MD)
Entity Type:Individual
Prefix:DR
First Name:MARVIN
Middle Name:A
Last Name:WEINAR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:500 GROVE ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HADDON HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08035-1761
Mailing Address - Country:US
Mailing Address - Phone:856-796-9200
Mailing Address - Fax:856-796-9397
Practice Address - Street 1:200 CAMPBELL DR
Practice Address - Street 2:SUITE 102
Practice Address - City:WILLINGBORO
Practice Address - State:NJ
Practice Address - Zip Code:08046-1067
Practice Address - Country:US
Practice Address - Phone:609-877-4545
Practice Address - Fax:609-877-5129
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2012-07-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMA42581207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1948847OtherUNITED HEALTHCARE
3K5945OtherHEALTHNET
9243538OtherCIGNA
0070238000OtherAMERIHEALTH, KEYSTONE , IBC
P369990OtherOXFORD
1079534OtherHORIZON NJ HEALTH
NJ1595806Medicaid
010002170OtherAMERICHOICE
NJ080128744OtherINDIVIDUAL RR PTAN
19323OtherUNIVERSITY HEALTHPLAN
0010419OtherAETNA
080128744OtherRR MEDICARE
19323OtherUNIVERSITY HEALTHPLAN
010002170OtherAMERICHOICE