Provider Demographics
NPI:1366448409
Name:WEISS, MICHELLE MELANIE (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:MELANIE
Last Name:WEISS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2605 JOPPA RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-5164
Mailing Address - Country:US
Mailing Address - Phone:717-747-5777
Mailing Address - Fax:717-747-5222
Practice Address - Street 1:2605 JOPPA RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5164
Practice Address - Country:US
Practice Address - Phone:717-747-5777
Practice Address - Fax:717-747-5222
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-23
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD048457L207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG09351Medicare UPIN