Provider Demographics
NPI:1235365990
Name:WEIGLE, KERI ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:KERI
Middle Name:ELIZABETH
Last Name:WEIGLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KERI
Other - Middle Name:ELIZABETH
Other - Last Name:QUINN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:781 AVENT FERRY RD STE 214
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-7776
Mailing Address - Country:US
Mailing Address - Phone:919-784-7874
Mailing Address - Fax:919-784-2708
Practice Address - Street 1:781 AVENT FERRY RD STE 214
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-7776
Practice Address - Country:US
Practice Address - Phone:919-784-7874
Practice Address - Fax:919-784-2708
Is Sole Proprietor?:No
Enumeration Date:2009-06-08
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60918827208600000X
NC2021-02094208600000X
CAA130738204F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB220795Medicare PIN