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General NPI Number Information
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NPI Number | 1023060027
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Entity Type | Individual
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Provider Name | THAIS DORRYNNE WEIBEL MD
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Gender | Female
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 01/08/2008
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Provider Practice Location Address
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Address Line | 11055 LITTLE PATUXENT PKWY SUITE 109
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City | COLUMBIA
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State | MD
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Zip | 21044
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Country | US
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Telephone | 410-977-1928
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Fax | 410-977-1929
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Provider Business Mailing Address
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Address Line | 4509 ROSEDALE AVE
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City | BETHSEDA
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State | MD
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Zip | 20814
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Country | US
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Telephone | 410-997-1928
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Fax | 410-997-1929
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | D0057645
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License Number State | MD
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