Healthcare Provider Details

I. General information

NPI: 1831176197
Provider Name (Legal Business Name): WILLIAM MARK WEISEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 08/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 W MAIN ST
MT PLEASANT PA
15666-1833
US

IV. Provider business mailing address

520 JEFFERSON AVE SUITE 400
JEANNETTE PA
15644-2538
US

V. Phone/Fax

Practice location:
  • Phone: 724-547-4536
  • Fax: 724-547-3799
Mailing address:
  • Phone: 724-527-8060
  • Fax: 724-613-5204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD020089E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: