Provider Demographics
NPI:1528020138
Name:WEINGARDEN, ALAN S (MD)
Entity Type:Individual
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First Name:ALAN
Middle Name:S
Last Name:WEINGARDEN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2080 WOODWINDS DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-2523
Mailing Address - Country:US
Mailing Address - Phone:651-738-6600
Mailing Address - Fax:651-738-6804
Practice Address - Street 1:2080 WOODWINDS DR
Practice Address - Street 2:SUITE 230
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-2523
Practice Address - Country:US
Practice Address - Phone:651-578-6949
Practice Address - Fax:651-578-3074
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-06
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MN29011207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA94024Medicare UPIN