Provider Demographics
NPI:1558472043
Name:WEIMAN, DARRYL SETH (MD)
Entity Type:Individual
Prefix:DR
First Name:DARRYL
Middle Name:SETH
Last Name:WEIMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10810 PARKSIDE DR STE 208
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-1981
Mailing Address - Country:US
Mailing Address - Phone:865-647-3350
Mailing Address - Fax:865-647-3359
Practice Address - Street 1:10810 PARKSIDE DR STE 208
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-1981
Practice Address - Country:US
Practice Address - Phone:865-647-3350
Practice Address - Fax:865-647-3359
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN024641208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ050902Medicaid