Provider Demographics
NPI:1528026317
Name:WEYN, DAVID CHRISTOPHER (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CHRISTOPHER
Last Name:WEYN
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 1:734 N 3RD ST
Mailing Address - Street 2:SUITE 115
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-5285
Mailing Address - Country:US
Mailing Address - Phone:352-365-2583
Mailing Address - Fax:352-728-6749
Practice Address - Street 1:801 E DIXIE AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-7601
Practice Address - Country:US
Practice Address - Phone:352-365-2583
Practice Address - Fax:352-728-6749
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME617132085R0202X
FL61713207RM1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No207RM1200XAllopathic & Osteopathic PhysiciansInternal MedicineMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL370284700Medicaid
FL300114874OtherRR MEDICARE RACF
FL300094757OtherRR MEDICARE LMIV
FL300114874OtherRR MEDICARE RACF
FL370284700Medicaid
FL14870WMedicare PIN