Provider Demographics
NPI:1427544220
Name:WEINSTOCK, HILLARD (MD)
Entity Type:Individual
Prefix:DR
First Name:HILLARD
Middle Name:
Last Name:WEINSTOCK
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 1:1790 HOMESTEAD AVE NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306-3136
Mailing Address - Country:US
Mailing Address - Phone:404-875-1490
Mailing Address - Fax:
Practice Address - Street 1:12 CORPORATE BLVD NE
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:GA
Practice Address - Zip Code:30329-1909
Practice Address - Country:US
Practice Address - Phone:404-639-2059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-03
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA30399207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine