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Individual

DR. LARRY A WEINRAUCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
521 MOUNT AUBURN ST, SUITE 204, WATERTOWN, MA 02472-4191
(617) 923-0800
(617) 926-5665
Mailing address
521 MOUNT AUBURN ST, SUITE 204, WATERTOWN, MA 02472-4191
(617) 923-0800
(617) 926-5665

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
35819
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
035819
TUFTS
MA
01
04-2726136
COST CARE
MA
05
2033704
MA
01
2257836
AETNA
MA
01
3235
HARVARD PILGRIM
MA
01
M13372
BLUE CROSS BLUE SHIELD
MA
Enumeration date
08/12/2006
Last updated
07/08/2007
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