Provider Demographics
NPI:1154324085
Name:WEINBERG, ROSS (DC)
Entity Type:Individual
Prefix:DR
First Name:ROSS
Middle Name:
Last Name:WEINBERG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2080 OLD BRIDGE RD
Mailing Address - Street 2:STE 201
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-2491
Mailing Address - Country:US
Mailing Address - Phone:703-497-2020
Mailing Address - Fax:703-492-6105
Practice Address - Street 1:2080 OLD BRIDGE RD
Practice Address - Street 2:STE 201
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-2491
Practice Address - Country:US
Practice Address - Phone:703-497-2020
Practice Address - Fax:703-492-6105
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000798111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA231686OtherBC/BS
VA504133OtherNCPPO
VA75190OtherNCAS
VA9430604001OtherCIGNA
VAS398-001OtherCAREFIRST
VA1023916OtherAETNA HEALTHCARE
VA215560OtherMDIPA, MAMSI
VA1023916OtherAETNA HEALTHCARE
VA9430604001OtherCIGNA