Provider Demographics
NPI:1679789010
Name:WINAS, JUSTIN SETH (DO)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:SETH
Last Name:WINAS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:291 CARTER DR STE A
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-5845
Mailing Address - Country:US
Mailing Address - Phone:844-365-7246
Mailing Address - Fax:844-516-0080
Practice Address - Street 1:535 PENNSYLVANIA AVE STE 100
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:19034
Practice Address - Country:US
Practice Address - Phone:215-646-6023
Practice Address - Fax:844-516-0080
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS014022207LP2900X, 207L00000X, 208VP0000X
DEC2-0012281208VP0000X
MDH0091267208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD888314900Medicaid
PA102183969Medicaid
DE250532375Medicaid