Healthcare Provider Details

I. General information

NPI: 1467434605
Provider Name (Legal Business Name): SUSAN M WEYER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2005
Last Update Date: 11/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2820 NAPOLEON AVE SUITE 890
NEW ORLEANS LA
70115-6969
US

IV. Provider business mailing address

1340 POYDRAS ST SUITE 1640
NEW ORLEANS LA
70112-1221
US

V. Phone/Fax

Practice location:
  • Phone: 504-412-1366
  • Fax: 504-412-1367
Mailing address:
  • Phone: 504-412-1835
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number014225
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: