MEDICARE: DR. THOMAS WEISMAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	35.038338	OH

General Provider Information

NPI Number	:	1366562498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS WEISMAN M.D.

Provider Business Mailing Address
First Line	:	25435 PENSHURST DR
Second Line	:
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-1372
Country	:	US
Telephone Number	:	216-831-0875
Fax Number	:

Provider Business Practice Location Address
First Line	:	8333 ROCKSIDE RD
Second Line	:
City	:	VALLEY VIEW
State	:	OH
Zip	:	44125-6134
Country	:	US
Telephone Number	:	216-573-4508
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2007
Last Update Date	:	07/08/2007

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