Healthcare Provider Details

I. General information

NPI: 1336247105
Provider Name (Legal Business Name): STEVEN DARROW WEISBORD MD, MSC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 09/24/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

623 ATWELLS AVENUE EAGLE SQUARE VA BOSTON HEALTHCARE SYSTEM
PROVIDENCE RI
02909
US

IV. Provider business mailing address

7008 REYNOLDS ST
PITTSBURGH PA
15208-2852
US

V. Phone/Fax

Practice location:
  • Phone: 857-579-4103
  • Fax:
Mailing address:
  • Phone: 412-371-5477
  • Fax: 412-688-6908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberMD068880L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: