Provider Demographics
NPI:1366447872
Name:WEISS, DAVID W (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:W
Last Name:WEISS
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:1700 N MOORE ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22209-2793
Mailing Address - Country:US
Mailing Address - Phone:703-524-7111
Mailing Address - Fax:703-524-0342
Practice Address - Street 1:1700 N MOORE ST
Practice Address - Street 2:SUITE 300
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22209-2793
Practice Address - Country:US
Practice Address - Phone:703-524-7111
Practice Address - Fax:703-524-0342
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-21
Last Update Date:2011-11-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0618000146152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAU70514Medicare UPIN
VA490087Medicare PIN