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NPI Code Detail

MEDICARE: DR. MARK D WEISSMAN M.D.

MEDICARE:  DR. MARK D WEISSMAN  M.D.
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
1207P00000XEmergency Medicine Physician01040184AIN
2207P00000XEmergency Medicine Physician33134020WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366426538
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK D WEISSMAN M.D.
Provider Business Mailing Address
First Line : PO BOX 735044
Second Line :
City : CHICAGO
State : IL
Zip : 60673-5044
Country : US
Telephone Number : 800-326-2250
Fax Number :
Provider Business Practice Location Address
First Line : 3003 UNIVERSITY DR
Second Line :
City : MARINETTE
State : WI
Zip : 54143-4110
Country : US
Telephone Number : 715-735-4200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2005
Last Update Date : 03/07/2025

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Directions to “ DR. MARK D WEISSMAN M.D.” Practice Location

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