Provider Demographics
NPI:1073711255
Name:ROBERT J WEIERMAN MD PLLC
Entity Type:Organization
Organization Name:ROBERT J WEIERMAN MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:WEIERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:228-575-6927
Mailing Address - Street 1:1213 BROAD AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39501-2475
Mailing Address - Country:US
Mailing Address - Phone:228-575-6927
Mailing Address - Fax:228-575-6929
Practice Address - Street 1:1213 BROAD AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39501-2475
Practice Address - Country:US
Practice Address - Phone:228-575-6927
Practice Address - Fax:228-575-6929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSC02984Medicare UPIN
MS200000431Medicare PIN