Healthcare Provider Details

I. General information

NPI: 1023059680
Provider Name (Legal Business Name): ADAM C. WEISER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 06/23/2023
Certification Date: 06/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 TECH CENTER DRIVE SUITE 250
COLUMBUS OH
43230-1987
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-396-2684
  • Fax: 614-396-2480
Mailing address:
  • Phone: 740-845-7700
  • Fax: 740-845-7701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number35081989
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: