Individual
BRENT WEINERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
897 BRIDGE ST, PHILA, PA 19124-1724
(215) 288-7000
(215) 288-7917
Mailing address
897 BRIDGE ST, PHILADELPHIA, PA 19124-1724
(215) 288-7222
(215) 288-7917
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
OS004236L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7030010
—
PA
Enumeration date
07/28/2006
Last updated
07/08/2007
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