Provider Demographics
NPI:1669734844
Name:WEINREICH, MICHAEL ALEXANDER (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ALEXANDER
Last Name:WEINREICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 RIVERSIDE AVE
Mailing Address - Street 2:MB665A 6TH FLOOR, EAST BUILDING, DELIVERY CODE 8952A
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55454-1450
Mailing Address - Country:US
Mailing Address - Phone:612-624-3113
Mailing Address - Fax:612-626-6601
Practice Address - Street 1:2450 RIVERSIDE AVE
Practice Address - Street 2:MB665A 6TH FLOOR, EAST BUILDING, DELIVERY CODE 8952A
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-1450
Practice Address - Country:US
Practice Address - Phone:612-624-3113
Practice Address - Fax:612-626-6601
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-13
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program