MEDICARE: DR. DAVID WEITZMAN 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	207P00000X	Emergency Medicine Physician	53530	WI
2	207P00000X	Emergency Medicine Physician	71752	GA
3	207P00000X	Emergency Medicine Physician	01071702-A	IN
4	207P00000X	Emergency Medicine Physician	39135	SC
5	207Q00000X	Family Medicine Physician	01071702	IN
6	207Q00000X	Family Medicine Physician	39135	SC
7	207Q00000X	Family Medicine Physician	53530	WI
8	2086S0129X	Vascular Surgery Physician	39135	SC
9	2086S0129X	Vascular Surgery Physician	71752	GA
10	207Q00000X	Family Medicine Physician	71752	GA
11	207QA0401X	Addiction Medicine (Family Medicine) Physician	01071702	IN
12	207QA0401X	Addiction Medicine (Family Medicine) Physician	71752	GA
13	207QA0401X	Addiction Medicine (Family Medicine) Physician	39135	SC
14	207QA0401X	Addiction Medicine (Family Medicine) Physician	53530	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	071752	OTHER	GA	GA MED LIC
2	01071702A	OTHER	IN	IN MED LICENSE
3	39135	OTHER	SC	SC LICENSE
4	53530-20	OTHER	WI	STATE OF WISCONSIN

General Provider Information

NPI Number	:	1376776781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID WEITZMAN M.D.

Provider Business Mailing Address
First Line	:	4701 S OCEAN BLVD APT 5F
Second Line	:
City	:	NORTH MYRTLE BEACH
State	:	SC
Zip	:	29582-5367
Country	:	US
Telephone Number	:	843-222-5395
Fax Number	:	866-340-0296

Provider Business Practice Location Address
First Line	:	1016 2ND AVE N STE 203
Second Line	:
City	:	NORTH MYRTLE BEACH
State	:	SC
Zip	:	29582-3288
Country	:	US
Telephone Number	:	843-222-5395
Fax Number	:	866-340-0296

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

Provider Enumeration Date	:	09/01/2009
Last Update Date	:	03/20/2024

Similar Medicare Providers

1063561082 — MARYANNE ZABRYCKI
Practice Location Address:

1016 2ND AVE N STE 205
NORTH MYRTLE BEACH, SC
29582-3288

Practice Phone: 843-491-3344
Practice Fax:

1174993273 — KRISTINE KUPCHA MA
Practice Location Address:

1016 2ND AVE N STE 203C
NORTH MYRTLE BEACH, SC
29582-3288

Practice Phone: 802-363-6188
Practice Fax:

1164892063 — CHAD EVAN WATTS PA-C
Practice Location Address:

1016 2ND AVE N STE 203F
NORTH MYRTLE BEACH, SC
29582-3288

Practice Phone: 843-273-9000
Practice Fax:

1093373813 — SUSAN LANG DBA A PLACE TO START
Practice Location Address:

1016 2ND AVE N STE 205
NORTH MYRTLE BEACH, SC
29582-3288

Practice Phone: 843-491-3344
Practice Fax: 843-491-3399

1295381531 — TONYA CANDICE WEBER
Practice Location Address:

1016 2ND AVE N STE 205
NORTH MYRTLE BEACH, SC
29582-3288

Practice Phone: 843-653-8007
Practice Fax:

1740997956 — SAVANNAH THAMES APRN, PMHNP
Practice Location Address:

1016 2ND AVE N STE 205
NORTH MYRTLE BEACH, SC
29582-3288

Practice Phone: 843-491-3344
Practice Fax:

Directions to “ DR. DAVID WEITZMAN M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.