Provider Demographics
NPI:1982808697
Name:WEINBERGER, STANLEY JOHN III (MD)
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:JOHN
Last Name:WEINBERGER
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:STAN
Other - Middle Name:
Other - Last Name:WEINBERGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1 S PROSPECT ST
Mailing Address - Street 2:UNIVERSITY PEDIATRICS, ARNOLD 3, UHC
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-3456
Mailing Address - Country:US
Mailing Address - Phone:802-847-4696
Mailing Address - Fax:
Practice Address - Street 1:1 S PROSPECT ST
Practice Address - Street 2:UNIVERSITY PEDIATRICS, ARNOLD 3, UHC
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-3456
Practice Address - Country:US
Practice Address - Phone:802-847-4696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042-0012002208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics