MEDICARE: ANNE C WEISS DO

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	2084N0400X	Neurology Physician	26515	WI

General Provider Information

NPI Number	:	1386617991
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNE C WEISS DO

Provider Business Mailing Address
First Line	:	2006 VAN HISE AVE
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53726-4055
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2006 VAN HISE AVE
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53726-4055
Country	:	US
Telephone Number	:	608-236-2171
Fax Number	:

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

Provider Enumeration Date	:	02/13/2006
Last Update Date	:	07/17/2020

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