Provider Demographics
NPI:1740288083
Name:WEINBERG, ADON S (DO)
Entity type:Individual
Prefix:DR
First Name:ADON
Middle Name:S
Last Name:WEINBERG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4247 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-1003
Mailing Address - Country:US
Mailing Address - Phone:330-759-9595
Mailing Address - Fax:330-759-9597
Practice Address - Street 1:4247 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-1003
Practice Address - Country:US
Practice Address - Phone:330-759-9595
Practice Address - Fax:330-759-9597
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-11
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-00-3133-W207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AD9326372Medicare ID - Type Unspecified
AD9326371Medicare ID - Type Unspecified
A79958Medicare UPIN