Provider Demographics
NPI:1649235078
Name:WEINERMAN, STEWART KENT (MD)
Entity Type:Individual
Prefix:MR
First Name:STEWART
Middle Name:KENT
Last Name:WEINERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1411 SO POTOMAC ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012
Mailing Address - Country:US
Mailing Address - Phone:303-695-6060
Mailing Address - Fax:303-369-7776
Practice Address - Street 1:1411 SO POTOMAC ST
Practice Address - Street 2:SUITE 400
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012
Practice Address - Country:US
Practice Address - Phone:303-695-6060
Practice Address - Fax:303-369-7776
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO27640207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01276401Medicaid
CO01276401Medicaid
COCL8248Medicare ID - Type Unspecified