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General NPI Number Information
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NPI Number | 1912197146
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Entity Type | Individual
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Provider Name | WILLIAM JEFFREY WEILY DPM
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Gender | Male
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Dates
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Enumeration Date | 07/25/2007
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 10370 PARK RD STE 100
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City | CHARLOTTE
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State | NC
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Zip | 28210-8509
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Country | US
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Telephone | 704-542-8253
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 825159
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City | PHILADELPHIA
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State | PA
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Zip | 19182-5159
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Country | US
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Telephone | 301-933-7133
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Fax | 704-541-0186
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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 | 752
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 10477
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License Number State | WV
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