MEDICARE: MRS. ERIN FAY WEIDMAN RDH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	124Q00000X	Dental Hygienist	5816	MD

General Provider Information

NPI Number	:	1003740630
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ERIN FAY WEIDMAN RDH

Provider Business Mailing Address
First Line	:	509 ISAAC RUSSELL ST
Second Line	:
City	:	NEW MARKET
State	:	MD
Zip	:	21774-6569
Country	:	US
Telephone Number	:	240-422-1970
Fax Number	:

Provider Business Practice Location Address
First Line	:	616 FREDERICK RD
Second Line	:
City	:	CATONSVILLE
State	:	MD
Zip	:	21228-4625
Country	:	US
Telephone Number	:	410-747-1116
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2026
Last Update Date	:	06/09/2026

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