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General NPI Number Information
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NPI Number | 1891781019
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Entity Type | Individual
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Provider Name | BRIAN J WEISS DPM
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Gender | Male
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Dates
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Enumeration Date | 09/22/2005
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Last Update Date | 11/28/2012
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Provider Practice Location Address
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Address Line | 5035 MAYFIELD RD SUITE #215
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City | LYNDHURST
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State | OH
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Zip | 44124-2688
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Country | US
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Telephone | 440-382-8070
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Fax | 216-382-6767
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Provider Business Mailing Address
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Address Line | 5035 MAYFIELD RD SUITE #215
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City | LYNDHURST
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State | OH
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Zip | 44124-2688
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Country | US
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Telephone | 440-382-8070
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Fax | 216-382-6767
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 36-00-2169-W
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License Number State | OH
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