Provider Demographics
NPI:1770707606
Name:WEINER, ALAN NORTON (DO)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:NORTON
Last Name:WEINER
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 1:4 MILK ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-4164
Mailing Address - Country:US
Mailing Address - Phone:207-828-8080
Mailing Address - Fax:207-828-6816
Practice Address - Street 1:4 MILK ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-4164
Practice Address - Country:US
Practice Address - Phone:207-828-8080
Practice Address - Fax:207-828-6816
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME8722083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine