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General NPI Number Information
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NPI Number | 1043351943
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Entity Type | Individual
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Provider Name | DENISE H WEIMER PA-C, MS
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Gender | Female
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 600 NORTH WOLFE ST. BLALOCK 616
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City | BALTIMORE
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State | MD
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Zip | 21287
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Country | US
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Telephone | 410-434-1115
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Fax |
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Provider Business Mailing Address
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Address Line | 369 LAKE RD
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City | CROWNSVILLE
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State | MD
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Zip | 21032
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Country | US
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Telephone | 443-822-6817
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Fax |
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | C0002289
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License Number State | MD
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