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General NPI Number Information
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NPI Number | 1073696126
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Entity Type | Organization
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Legal Business Name | SCOTT R WEISBERG MD, PC
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 06/20/2011
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Provider Practice Location Address
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Address Line | 2151 HIGHLAND AVE S SUITE 320
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City | BIRMINGHAM
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State | AL
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Zip | 35205-4079
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Country | US
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Telephone | 205-877-8677
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Fax | 205-877-8675
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Provider Business Mailing Address
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Address Line | 2151 HIGHLAND AVE S SUITE 320
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City | BIRMINGHAM
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State | AL
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Zip | 35205-4079
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Country | US
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Telephone | 205-877-8677
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Fax | 205-877-8675
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Authorized Official
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Title or Position | OWNER OF PC
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Name | SCOTT ROSS WEISBERG
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Credential | MD
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Telephone | 205-877-8677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 22747
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License Number State | AL
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