1063482289 NPI number — DR. JOEL W WINER M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063482289 NPI number — DR. JOEL W WINER M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

WINER

Provider First Name:

JOEL

Provider Middle Name:

W

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1063482289

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

03/07/2018

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

1803 MOUNT ROSE AVE

Provider Second Line Business Mailing Address:

SUITE B3

Provider Business Mailing Address City Name:

YORK

Provider Business Mailing Address State Name:

PA

Provider Business Mailing Address Postal Code:

17403-3026

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

717-851-1405

Provider Business Mailing Address Fax Number:

717-741-3598

Provider First Line Business Practice Location Address:

228 SAINT CHARLES WAY STE 300

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

YORK

Provider Business Practice Location Address State Name:

PA

Provider Business Practice Location Address Postal Code:

17402-4661

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

717-812-5400

Provider Business Practice Location Address Fax Number:

717-741-3598

Provider Enumeration Date:

01/23/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207T00000X , with the licence number:  MD040236L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 38610 . This is a "GEISINGER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 50060997 . This is a "CAPITAL BLUE CROSS-WMG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 033266 . This is a "JOHNS HOPKINS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 3114623 . This is a "MAMSI-WMG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 4568518 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 571809 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 0505012000 . This is a "AMERIHEALTH 65 PA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 889459 . This is a "CAREFIRST MD BCBS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 186767 . This is a "UNISON-WMG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 7671809 . This is a "GATEWAY-WMG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 001288687 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
• Identifier: 20054028 . This is a "AMERIHEALTH MERCY-WMG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".