| Lewis R. Weiner, M.d., Inc. | |
|
1 Davol Sq #304 Providence RI 02903-4755 | |
| (401) 369-7070 | |
| (401) 369-7080 |
| Full Name | Lewis R. Weiner, M.d., Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1 Davol Sq, Providence, Rhode Island |
| Authorized Official Name and Position | Lewis R. Weiner (PRESIDENT) |
| Authorized Official Contact | 4013697070 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lewis R. Weiner, M.d., Inc. 1 Davol Sq #304 Providence RI 02903-4755 Ph: (401) 369-7070 | Lewis R. Weiner, M.d., Inc. 1 Davol Sq #304 Providence RI 02903-4755 Ph: (401) 369-7070 |
| NPI Number | 1972721157 |
|---|---|
| Provider Enumeration Date | 04/23/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 5092744433 |
|---|---|
| Medicare Enrollment ID | O20050805000863 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972721157 | NPI | - | NPPES |
| 9006564 | Medicaid | RI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 07384 (Rhode Island) | Primary |
| Provider Name | Lewis R Weiner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780624601 PECOS PAC ID: 9234024068 Enrollment ID: I20040614000951 |
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