Provider Demographics
NPI:1154327088
Name:WEPRIN, STUART ALAN (MD)
Entity Type:Individual
Prefix:
First Name:STUART
Middle Name:ALAN
Last Name:WEPRIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 W WENGER RD
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45322-2722
Mailing Address - Country:US
Mailing Address - Phone:937-771-5100
Mailing Address - Fax:937-832-3014
Practice Address - Street 1:20 W WENGER RD
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:OH
Practice Address - Zip Code:45322-2722
Practice Address - Country:US
Practice Address - Phone:937-771-5100
Practice Address - Fax:937-832-3014
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-24
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35038050207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0398412Medicaid
OH160026506Medicare PIN
OHA78877Medicare UPIN
OHH110921Medicare PIN