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General NPI Number Information
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NPI Number | 1154536597
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Entity Type | Organization
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Legal Business Name | PAUL D WEIDMAN, MD PLLC
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 08/10/2015
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Provider Practice Location Address
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Address Line | 106 PLAZA DR
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City | SAINT CLAIRSVILLE
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State | OH
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Zip | 43950-6700
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Country | US
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Telephone | 740-296-5159
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Fax | 740-695-5168
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Provider Business Mailing Address
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Address Line | 105 PLAZA DRIVE WEST
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City | ST CLAIRSVILLE
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State | OH
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Zip | 43950-1540
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Country | US
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Telephone | 740-296-5159
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Fax | 740-296-5168
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Authorized Official
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Title or Position | SOLE PROPRIETER
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Name | PAUL DANIEL WEIDMAN
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Credential | MD
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Telephone | 740-296-5159
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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 | 3584922
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License Number State | OH
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