Provider Demographics
NPI:1396842878
Name:WEINSTEIN, ADAM JACOB (MD)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:JACOB
Last Name:WEINSTEIN
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 1:5 MARTIN COURT
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-4039
Mailing Address - Country:US
Mailing Address - Phone:410-820-9823
Mailing Address - Fax:866-606-6428
Practice Address - Street 1:5 MARTIN COURT
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-4039
Practice Address - Country:US
Practice Address - Phone:410-820-9823
Practice Address - Fax:866-606-6428
Is Sole Proprietor?:No
Enumeration Date:2006-09-19
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0063802207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD413230100Medicaid
MD317P635GMedicare PIN
MDI63775Medicare UPIN