MEDICARE: DR. HANS E. VON WEISS DO

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	207N00000X	Dermatology Physician	57672	WI
2	207N00000X	Dermatology Physician	744667	MA

General Provider Information

NPI Number	:	1689667313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HANS E. VON WEISS DO

Provider Business Mailing Address
First Line	:	200 1ST ST SW
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55905-0002
Country	:	US
Telephone Number	:	715-838-5222
Fax Number	:

Provider Business Practice Location Address
First Line	:	191 THEATER ROAD
Second Line	:
City	:	ONALASKA
State	:	WI
Zip	:	54650-8679
Country	:	US
Telephone Number	:	608-392-5000
Fax Number	:

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

Provider Enumeration Date	:	08/29/2005
Last Update Date	:	09/13/2021

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