Provider Demographics
NPI:1447226659
Name:WEINSTOCK, DAVID E (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:E
Last Name:WEINSTOCK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 HAMPTON ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01501-2584
Mailing Address - Country:US
Mailing Address - Phone:508-753-2060
Mailing Address - Fax:508-752-4244
Practice Address - Street 1:250 HAMPTON ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:MA
Practice Address - Zip Code:01501-2584
Practice Address - Country:US
Practice Address - Phone:508-753-2060
Practice Address - Fax:508-752-4244
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA216941207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA696908OtherHARAVARD PILGRIM HEALTH
MA97293701OtherNETWORK HEALTH
MA110033815AMedicaid
MA59634OtherFALLON HEALTH
MAJ26154OtherBLUE SHIELD OF MA
MAH86168Medicare UPIN
MAJ26154OtherBLUE SHIELD OF MA
MAMX7449Medicare PIN