Provider Demographics
NPI:1598863367
Name:WEINER, STANTON DAVID (DO)
Entity Type:Individual
Prefix:DR
First Name:STANTON
Middle Name:DAVID
Last Name:WEINER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1401 CHURCH ST NW APT 524
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20005-2057
Mailing Address - Country:US
Mailing Address - Phone:202-997-1857
Mailing Address - Fax:301-762-6646
Practice Address - Street 1:14800 PHYSICIANS LN STE 234
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3940
Practice Address - Country:US
Practice Address - Phone:301-762-6686
Practice Address - Fax:301-762-6646
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDH0050666208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation