Provider Demographics
NPI:1497211924
Name:JOHN J. WEITER, MD PC
Entity Type:Organization
Organization Name:JOHN J. WEITER, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:WEITER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-854-5090
Mailing Address - Street 1:39 CROSS ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960
Mailing Address - Country:US
Mailing Address - Phone:978-854-5090
Mailing Address - Fax:978-854-5755
Practice Address - Street 1:100 MILK STREET
Practice Address - Street 2:SUITE 202
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-4662
Practice Address - Country:US
Practice Address - Phone:978-854-5090
Practice Address - Fax:978-854-5755
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOHN J WEITER, MD, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-20
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier