Provider Demographics
NPI:1578610325
Name:DENTON D WEISS MD PLC
Entity Type:Organization
Organization Name:DENTON D WEISS MD PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENTON
Authorized Official - Middle Name:D
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-490-7545
Mailing Address - Street 1:272 BENDIX RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-1367
Mailing Address - Country:US
Mailing Address - Phone:757-490-7545
Mailing Address - Fax:757-490-7549
Practice Address - Street 1:272 BENDIX RD
Practice Address - Street 2:SUITE 100
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1367
Practice Address - Country:US
Practice Address - Phone:757-490-7545
Practice Address - Fax:757-490-7549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAH34087Medicare UPIN
VAC09948Medicare PIN