MEDICARE: DR. WILLIAM JEFFREY WEILY DPM

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	213E00000X	Podiatrist	752	NC
2	213E00000X	Podiatrist	10477	WV

General Provider Information

NPI Number	:	1912197146
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM JEFFREY WEILY DPM

Provider Business Mailing Address
First Line	:	PO BOX 825159
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19182-5159
Country	:	US
Telephone Number	:	301-933-7133
Fax Number	:	704-541-0186

Provider Business Practice Location Address
First Line	:	10370 PARK RD STE 100
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28210-8509
Country	:	US
Telephone Number	:	704-542-8253
Fax Number	:

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

Provider Enumeration Date	:	07/25/2007
Last Update Date	:	09/04/2025

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