1831106269 NPI number — LAWRENCE C WEI M.D.

Table of content: LAWRENCE C WEI M.D. (NPI 1831106269)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831106269 NPI number — LAWRENCE C WEI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WEI
Provider First Name:
LAWRENCE
Provider Middle Name:
C
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

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 Information

NPI Number:
1831106269
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/27/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1001 E 2ND ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COUDERSPORT
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16915-8161
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-274-7910
Provider Business Mailing Address Fax Number:
814-274-8213

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1001 E 2ND ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COUDERSPORT
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16915-8161
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-274-7910
Provider Business Practice Location Address Fax Number:
814-274-8213
Provider Enumeration Date:
08/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  MD033374E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 5035931 . This is a "WESTERN NEW YORK BC/BS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 220038 . This is a "UPMC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 180003352 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: P013516 . This is a "CHAMPUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0010078660005 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 723061 . This is a "HIGHMARK BLUE SHIELD" identifier . This identifiers is of the category "OTHER".




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