Provider Demographics
NPI:1174685390
Name:WEIL, DANIEL PETER (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:PETER
Last Name:WEIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 SPRUCE ST
Mailing Address - Street 2:DULLES BLDG. STE 680
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4206
Mailing Address - Country:US
Mailing Address - Phone:215-514-4365
Mailing Address - Fax:
Practice Address - Street 1:3400 SPRUCE ST
Practice Address - Street 2:DULLES BLDG. STE 680
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4206
Practice Address - Country:US
Practice Address - Phone:215-514-4365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10772600207L00000X
PAMD431077207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000000242913OtherUNISON
PA1021234600001Medicaid
PA823147Other1ST HEALTH PRIORITY
PA119185OtherGEISINGER
NJ0162922Medicaid
PA50077669OtherCAPITAL ADVANTAGE
PA2022445OtherHIGHMARK
NJ0162922Medicaid