Provider Demographics
NPI:1902891229
Name:WENIG, LINDA NEWCOMB (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:NEWCOMB
Last Name:WENIG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:843 W INGOMAR RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-4304
Mailing Address - Country:US
Mailing Address - Phone:412-780-8912
Mailing Address - Fax:
Practice Address - Street 1:720 BLACKBURN RD
Practice Address - Street 2:HERITAGE VALLEY SEWICKLY
Practice Address - City:SEWICKLY
Practice Address - State:PA
Practice Address - Zip Code:15143-1498
Practice Address - Country:US
Practice Address - Phone:724-728-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD050894L207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810008866Medicaid
PA0018792600001Medicaid
OH2439409Medicaid
WV3810008866Medicaid
PA930116049Medicare PIN
PAH56664Medicare UPIN
PA0018792600001Medicaid