Provider Demographics
NPI:1225396740
Name:WEISZ, ALICE M (MD)
Entity Type:Individual
Prefix:DR
First Name:ALICE
Middle Name:M
Last Name:WEISZ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:6699 SPRINGFIELD CENTER DR
Mailing Address - Street 2:NVCC- MEC ROOM 239
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22150-1913
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6699 SPRINGFIELD CENTER DR
Practice Address - Street 2:NVCC- MEC ROOM 239
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-1913
Practice Address - Country:US
Practice Address - Phone:703-822-6557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-03
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101040110207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAU00177495Medicare UPIN