Provider Demographics
NPI:1174533418
Name:WEINBAUM, DAVID L (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:L
Last Name:WEINBAUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4778 LIBERTY AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-2040
Mailing Address - Country:US
Mailing Address - Phone:412-681-0966
Mailing Address - Fax:412-681-7914
Practice Address - Street 1:4778 LIBERTY AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-2040
Practice Address - Country:US
Practice Address - Phone:412-681-0966
Practice Address - Fax:412-681-7914
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD025911E207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0953890Medicaid
PA0953890Medicaid
PA189825H8RMedicare PIN