Provider Demographics
NPI:1376514042
Name:WEIXLER, WARREN PAUL (MD)
Entity Type:Individual
Prefix:
First Name:WARREN
Middle Name:PAUL
Last Name:WEIXLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:856 J CLYDE MORRIS BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1318
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2855 DENBIGH BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:YORKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23692-6501
Practice Address - Country:US
Practice Address - Phone:757-968-5700
Practice Address - Fax:757-968-5717
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101041408207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAB08268Medicare UPIN
VA1376514042Medicaid
VAP00953003Medicare PIN
VAVV0086AMedicare PIN