Provider Demographics
NPI:1083608285
Name:WEISENBERGER, PAULA F (MD)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:F
Last Name:WEISENBERGER
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 1:5053 WOOSTER RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45226-2326
Mailing Address - Country:US
Mailing Address - Phone:513-751-2145
Mailing Address - Fax:513-751-2138
Practice Address - Street 1:3050 MACK RD
Practice Address - Street 2:STE 300
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-5379
Practice Address - Country:US
Practice Address - Phone:513-682-4800
Practice Address - Fax:513-682-4807
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY21186207RH0003X
IN01031784A207RH0003X
OH35037711207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100019990Medicaid
OH0453709Medicaid
KY64863111Medicaid
IN176760011Medicare PIN
IN176760GMedicare PIN
A79473Medicare UPIN
OH0453709Medicaid
KY64863111Medicaid