Provider Demographics
NPI:1467489146
Name:WEINTRAUB, WILLIAM S (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:S
Last Name:WEINTRAUB
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 1:4755 OGLETOWN STANTON ROAD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19718-0001
Mailing Address - Country:US
Mailing Address - Phone:302-733-1000
Mailing Address - Fax:
Practice Address - Street 1:4755 OGLETOWN STANTON ROAD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19718-0001
Practice Address - Country:US
Practice Address - Phone:302-733-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0007890207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEG02343C01Medicare PIN
018781C92Medicare ID - Type Unspecified
DED31278Medicare UPIN