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NPI Code Detail

MEDICARE: LAWRENCE RICHARD WEIL M.D.

MEDICARE: LAWRENCE RICHARD WEIL 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
12085R0202XDiagnostic Radiology Physician54602MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1699885673
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAWRENCE RICHARD WEIL M.D.
Provider Business Mailing Address
First Line : 350 BURROUGHS RD
Second Line :
City : BOXBOROUGH
State : MA
Zip : 01719-1916
Country : US
Telephone Number : 978-263-5497
Fax Number : 978-263-1226
Provider Business Practice Location Address
First Line : 350 BURROUGHS RD
Second Line :
City : BOXBOROUGH
State : MA
Zip : 01719-1916
Country : US
Telephone Number : 978-263-5497
Fax Number : 978-263-1226
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2006
Last Update Date : 07/08/2007

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