Weiner, Mark J
Weiner, Mark J is an sole proprietor health care provider with primary practice located at 1320 Oakside Dr S202, Canton GA 30114-2475. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Weiner, Mark J can be contacted via phone (770) 720-4041.Contact Information
Primary practice address
1320 Oakside Dr S202
Canton GA 30114-2475
Phone: (770) 720-4041
Fax: (770) 479-4857
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 33748 | Georgia |
Profile Details
| NPI number | 1184616047 |
|---|---|
| LBN Legal business name | Weiner, Mark J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 17th, 2005 |
| Last updated | Mar 14th, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184616047 | NPPES |
| Georgia | Other | 581937175 | TAX ID |
| Georgia | MEDICAID | 000439348B | TAX ID |
| Georgia | Other | 180010817 | TAX ID |
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