Healthcare Provider Details

I. General information

NPI: 1497695720
Provider Name (Legal Business Name): OREN SAMUEL WEISS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

733 N BROADWAY EDWARD D. MILLER RESEARCH BUILDING, SUITE 137
BALTIMORE MD
21205-2196
US

IV. Provider business mailing address

733 N BROADWAY EDWARD D. MILLER RESEARCH BUILDING, SUITE 137
BALTIMORE MD
21205-2196
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-3191
  • Fax: 410-955-0826
Mailing address:
  • Phone:
  • Fax: 410-955-0826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: