Basic Information
Provider Information
NPI: 1073728788
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WEIN
FirstName: SCOTT
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3001 EDWARDS MILL RD STE 200
Address2:  
City: RALEIGH
State: NC
PostalCode: 276125243
CountryCode: US
TelephoneNumber: 9197815600
FaxNumber: 9198636821
Practice Location
Address1: 3001 EDWARDS MILL RD
Address2: SUITE 200
City: RALEIGH
State: NC
PostalCode: 276125243
CountryCode: US
TelephoneNumber: 9197815600
FaxNumber: 9198636821
Other Information
ProviderEnumerationDate: 05/14/2007
LastUpdateDate: 05/06/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/06/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X2008-00178NCY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 
2086S0105X2008-00178NCN Allopathic & Osteopathic PhysiciansSurgerySurgery of the Hand

No ID Information.


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