Provider Demographics
NPI:1932314804
Name:WEINBERGER, BRADLEY CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:CHARLES
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 1:5870 CRESCENT RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SEVEN HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44131-2437
Mailing Address - Country:US
Mailing Address - Phone:216-712-6788
Mailing Address - Fax:216-712-6788
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-1913
Practice Address - Country:US
Practice Address - Phone:216-712-6788
Practice Address - Fax:216-712-6788
Is Sole Proprietor?:No
Enumeration Date:2007-05-13
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-091938208000000X
OH35.0919382080S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080S0010XAllopathic & Osteopathic PhysiciansPediatricsSports Medicine