Provider Demographics
NPI:1720061153
Name:WEINSTEIN, ADAM R (MD)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:R
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 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:DHMC--DEPT OF PEDIATRICS
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03756-0001
Mailing Address - Country:US
Mailing Address - Phone:603-653-9884
Mailing Address - Fax:603-650-0907
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:DHMC--DEPT OF PEDIATRICS
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03756-0001
Practice Address - Country:US
Practice Address - Phone:603-653-9884
Practice Address - Fax:603-650-0907
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH14529208000000X, 2080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1016636Medicaid
NH30208943Medicaid
VT1016636Medicaid
I37100Medicare UPIN
NH30208943Medicaid
NH001272301Medicare PIN