Provider Demographics
NPI:1134233984
Name:WEINER, SCOTT DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:DAVID
Last Name:WEINER
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 1:20 OLIVE ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44310-3165
Mailing Address - Country:US
Mailing Address - Phone:330-379-5051
Mailing Address - Fax:330-379-5074
Practice Address - Street 1:20 OLIVE ST
Practice Address - Street 2:SUITE 201
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44310-3165
Practice Address - Country:US
Practice Address - Phone:330-379-5051
Practice Address - Fax:330-379-5074
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35056055W207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0883218Medicaid
OH0883218Medicaid
OHWE0723681Medicare ID - Type Unspecified