Individual
SHOSHANA JO WEINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(617) 214-1332
(410) 328-8326
Mailing address
PO BOX 64442, BALTIMORE, MD 21264-4442
(667) 214-1332
(410) 328-8326
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101253875
VA
207R00000X
Internal Medicine Physician
Primary
D75548
MD
207R00000X
Internal Medicine Physician
MD041211
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S062-0600
CAREFIRST BC/BS
MD
Enumeration date
04/27/2010
Last updated
02/04/2016
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