Provider Demographics
NPI:1396785408
Name:WEINER, MILTON A (MD)
Entity type:Individual
Prefix:
First Name:MILTON
Middle Name:A
Last Name:WEINER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 1045
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01613-1045
Mailing Address - Country:US
Mailing Address - Phone:978-939-2035
Mailing Address - Fax:978-939-2039
Practice Address - Street 1:14 RICE RD
Practice Address - Street 2:
Practice Address - City:TEMPLETON
Practice Address - State:MA
Practice Address - Zip Code:01468-1332
Practice Address - Country:US
Practice Address - Phone:978-939-2035
Practice Address - Fax:978-939-2039
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA305342085R0202X, 2085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0191825OtherHEALTHY START
MA042477296OtherPRIVATE HEALTH CARE SYSTE
MA300041880OtherRAILDROAD MEDICARE
MA33770OtherFALLON COMMUNITY HEALTH P
MA0007041OtherNEIGHBORHOOD HEALTH PLAN
MA0191825Medicaid
MA98735402OtherNETWORK HEALTH
MA042477296OtherUNITED HEALTH CARE
MA40013OtherHEALTH NEW ENGLAND
MA7234OtherCIGNA
MA24946OtherHARVARD PILGRIM HEALTH CA
MA030534OtherTUFTS HEALTH PLAN
MA042477296OtherHEALTH CARE VALUE MANAGEM
MAM07245OtherBLUE CROSS BLUE SHIELD
MA24946OtherHARVARD PILGRIM HEALTH CA
MAM07245Medicare ID - Type Unspecified