Provider Demographics
NPI:1619978517
Name:WEINBERGER, RICHARD F (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:F
Last Name:WEINBERGER
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 1:3690 ORANGE PL
Mailing Address - Street 2:SUITE # 230
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4464
Mailing Address - Country:US
Mailing Address - Phone:216-765-1180
Mailing Address - Fax:216-765-1163
Practice Address - Street 1:3690 ORANGE PL
Practice Address - Street 2:SUITE # 230
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4464
Practice Address - Country:US
Practice Address - Phone:216-765-1180
Practice Address - Fax:216-765-1163
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35049250207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0556812Medicaid
OH341939070OtherBWC
OH35049250OtherLICENSE
OH35049250OtherLICENSE
OH341939070OtherBWC
OH0556812Medicaid