1215952130 NPI number — ROBERT & MARGARET WEISS MD P.A.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215952130 NPI number — ROBERT & MARGARET WEISS MD P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROBERT & MARGARET WEISS MD P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
MARYLAND LASER SKIN & VEIN INSTITUTE LLL
Provider Other Organization Name Type Code:
3
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 Information

NPI Number:
1215952130
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/10/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
54 SCOTT ADAM ROAD
Provider Second Line Business Mailing Address:
SUITE 301
Provider Business Mailing Address City Name:
HUNT VALLEY
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21030-3360
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-666-3960
Provider Business Mailing Address Fax Number:
410-666-3981

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
54 SCOTT ADAM ROAD
Provider Second Line Business Practice Location Address:
SUITE 301
Provider Business Practice Location Address City Name:
HUNT VALLEY
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21030-3360
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-666-3960
Provider Business Practice Location Address Fax Number:
410-666-3981
Provider Enumeration Date:
07/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SHOCK
Authorized Official First Name:
JO ANN
Authorized Official Middle Name:
B
Authorized Official Title or Position:
BILLING MANAGER
Authorized Official Telephone Number:
410-666-6240

Provider Taxonomy Codes

  • Taxonomy code: 207N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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