Healthcare Provider Details

I. General information

NPI: 1023361052
Provider Name (Legal Business Name): ST THOMAS NEUROLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2012
Last Update Date: 10/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9149 ESTATE THOMAS STE 209 PARAGON MEDICAL BLD
ST THOMAS VI
00802-3132
US

IV. Provider business mailing address

PO BOX 7307
ST THOMAS VI
00801-0307
US

V. Phone/Fax

Practice location:
  • Phone: 340-775-4666
  • Fax: 340-775-3650
Mailing address:
  • Phone: 340-775-4666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number1244
License Number StateVI

VIII. Authorized Official

Name: DAVID D WEISHER
Title or Position: PHYSICIAN / OWNER
Credential: M.D.
Phone: 340-775-4666