Provider Demographics
NPI:1487815635
Name:NATHAN WEI, MD, PA
Entity Type:Organization
Organization Name:NATHAN WEI, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEI, MD, PA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-624-1160
Mailing Address - Street 1:71 THOMAS JOHNSON DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4301
Mailing Address - Country:US
Mailing Address - Phone:301-624-1160
Mailing Address - Fax:
Practice Address - Street 1:71 THOMAS JOHNSON DR
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4301
Practice Address - Country:US
Practice Address - Phone:301-624-1160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-20
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA1263261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical