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Individual

MARTIN H WEINRAUCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2850 VILLAGE DR, SUITE 104, FAYETTEVILLE, NC 28304-3864
(910) 483-4687
(910) 483-4968
Mailing address
2850 VILLAGE DR, SUITE 104, FAYETTEVILLE, NC 28304-3864
(910) 483-4687
(910) 483-4968

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
9700802
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11579
BLUE SHIELD BLUE CROSS
NC
05
891096A
NC
Enumeration date
05/15/2006
Last updated
06/06/2016
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