Provider Demographics
NPI:1285627125
Name:WINNER, DAVID E (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:E
Last Name:WINNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1250 RALSTON AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:DEFIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:43512-5311
Mailing Address - Country:US
Mailing Address - Phone:419-784-3044
Mailing Address - Fax:419-784-1606
Practice Address - Street 1:1250 RALSTON AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:DEFIANCE
Practice Address - State:OH
Practice Address - Zip Code:43512-5311
Practice Address - Country:US
Practice Address - Phone:419-784-3044
Practice Address - Fax:419-784-1606
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2023-11-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35069202207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000338204OtherANTHEM
OH2039323Medicaid
OH22-18100OtherUHC
OH03154OtherPHC
OH03154OtherPHC
OH2039323Medicaid