Healthcare Provider Details

I. General information

NPI: 1093455883
Provider Name (Legal Business Name): AUSTIN WELD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2022
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15000 WESTON PKWY OFC 171
CARY NC
27513-2118
US

IV. Provider business mailing address

15000 WESTON PKWY OFC 171
CARY NC
27513-2118
US

V. Phone/Fax

Practice location:
  • Phone: 315-823-8255
  • Fax:
Mailing address:
  • Phone: 315-823-8255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2026-04545
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: