Provider Demographics
NPI:1023003712
Name:WEISS, NANCY LOUISE (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:LOUISE
Last Name:WEISS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 STANARD ST
Mailing Address - Street 2:BOX 54
Mailing Address - City:STANARDSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22973-3756
Mailing Address - Country:US
Mailing Address - Phone:434-985-7000
Mailing Address - Fax:434-985-4993
Practice Address - Street 1:39 STANARD ST
Practice Address - Street 2:BOX 54
Practice Address - City:STANARDSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22973-3756
Practice Address - Country:US
Practice Address - Phone:434-985-7000
Practice Address - Fax:434-985-4993
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-19
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA35526208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0101239874OtherVIRGINIA BOARD OF REGISTRATION IN MEDICINE
MAN51643Medicare ID - Type Unspecified
MAB99550Medicare UPIN