Individual
LAURENCE M WEINBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1691 GALISTEO ST, SUITE C, SANTA FE, NM 87505-4780
(505) 983-5631
(505) 982-5605
Mailing address
1691 GALISTEO STREET, SUITE C, SANTA FE, NM 87505
(505) 983-5631
(505) 982-5605
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD20090086
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010652890003
—
PA
Enumeration date
03/21/2006
Last updated
05/08/2012
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