Provider Demographics
NPI:1336177112
Name:WEINSTEIN, LOUIS W (MD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:W
Last Name:WEINSTEIN
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 1:1086 7TH AVE SW
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-1997
Mailing Address - Country:US
Mailing Address - Phone:541-967-4249
Mailing Address - Fax:541-928-2942
Practice Address - Street 1:1086 7TH AVE SW
Practice Address - Street 2:SUITE 101
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-1997
Practice Address - Country:US
Practice Address - Phone:541-967-4249
Practice Address - Fax:541-928-2942
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD10044207R00000X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORD73055Medicare UPIN