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1083777866

NPI Code Detail

MEDICARE: PEDRO WEISLEDER MD, PHD

MEDICARE: PEDRO WEISLEDER MD, PHD

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	2084N0402X	Neurology with Special Qualifications in Child Neurology Physician	35702	WV
2	2084N0402X	Neurology with Special Qualifications in Child Neurology Physician	35090080	OH
3	2084A0401X	Addiction Medicine (Psychiatry & Neurology) Physician	35090080	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4235414	OTHER	OH	CGS - MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083777866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PEDRO WEISLEDER MD, PHD

Provider Business Mailing Address
First Line	:	700 CHILDRENS DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43205-2664
Country	:	US
Telephone Number	:	614-722-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	555 S 18TH ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43205-2654
Country	:	US
Telephone Number	:	614-722-6200
Fax Number	:

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

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	01/13/2026

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Directions to “ PEDRO WEISLEDER MD, PHD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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