Provider Demographics
NPI:1760454177
Name:WEINSTEIN, TODD STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:STEVEN
Last Name:WEINSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1025 MICHIGAN AVE
Mailing Address - Street 2:STE 215
Mailing Address - City:LOGANSPORT
Mailing Address - State:IN
Mailing Address - Zip Code:46947-1594
Mailing Address - Country:US
Mailing Address - Phone:574-753-2222
Mailing Address - Fax:574-753-0522
Practice Address - Street 1:1025 MICHIGAN AVE
Practice Address - Street 2:STE 215
Practice Address - City:LOGANSPORT
Practice Address - State:IN
Practice Address - Zip Code:46947-1594
Practice Address - Country:US
Practice Address - Phone:574-753-2222
Practice Address - Fax:574-753-0522
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01039141208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100386140Medicaid
INP01066381OtherRAILROAD
IN000000775072OtherANTHEM
INM400074626Medicare PIN
IN100386140Medicaid
INM400074626Medicare PIN