Individual
MAXWELL ETHAN WEINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
201 E UNIVERSITY PKWY, BALTIMORE, MD 21218-2829
(410) 554-2000
Mailing address
124 ELLINGTON BLVD APT 533, GAITHERSBURG, MD 20878-4573
(214) 673-3619
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C0007949
MD
Other
Enumeration date
05/27/2021
Last updated
05/27/2021
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