Healthcare Provider Details

I. General information

NPI: 1265410393
Provider Name (Legal Business Name): CHRISTINE WEYMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 04/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 ROBERTS ST
SOMERSET KY
42501-1295
US

IV. Provider business mailing address

500 BOURNE AVE
SOMERSET KY
42501-1916
US

V. Phone/Fax

Practice location:
  • Phone: 606-679-4416
  • Fax: 606-679-4419
Mailing address:
  • Phone: 606-678-4761
  • Fax: 606-676-9671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number28428
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number28428
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: