Provider Demographics
NPI:1245225911
Name:WINERMAN, MARK A (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:A
Last Name:WINERMAN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 CHILDRENS DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-2664
Mailing Address - Country:US
Mailing Address - Phone:614-722-6200
Mailing Address - Fax:614-722-5176
Practice Address - Street 1:441 INDUSTRIAL MILE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-2458
Practice Address - Country:US
Practice Address - Phone:614-722-6200
Practice Address - Fax:614-722-5176
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.046153208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH566670OtherMEDICARE
OH0457670Medicaid
OHWI07771Medicare ID - Type Unspecified
OH000000126833OtherANTHEM BC/BS
OH1569810OtherUNITIED HEALTHCARE
OH4018324Medicare PIN
OH0457670Medicaid
OHF12426Medicare UPIN