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NPI Code Detail

MEDICARE: MICHAEL WEISNER

MEDICARE: MICHAEL WEISNER
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
1207Q00000XFamily Medicine PhysicianMD029362EPA

General Provider Information

NPI Number : 1114966850
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL WEISNER
Provider Business Mailing Address
First Line : 1201 GRAMPIAN BLVD
Second Line :
City : WILLIAMSPORT
State : PA
Zip : 17701-1900
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2901 JOLLY RD
Second Line :
City : PLYMOUTH MEETING
State : PA
Zip : 19462-2324
Country : US
Telephone Number : 610-272-8221
Fax Number : 610-272-5655
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2006
Last Update Date : 06/25/2024

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Directions to “ MICHAEL WEISNER ” Practice Location

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