Provider Demographics
NPI:1578641387
Name:WEISS, STEFAN C (MD)
Entity Type:Individual
Prefix:
First Name:STEFAN
Middle Name:C
Last Name:WEISS
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:PO BOX 2288
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27515-2288
Mailing Address - Country:US
Mailing Address - Phone:919-710-8100
Mailing Address - Fax:919-747-3999
Practice Address - Street 1:100 TIMBERHILL PL UNIT 110
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-1962
Practice Address - Country:US
Practice Address - Phone:919-710-8100
Practice Address - Fax:919-747-3999
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA80115207N00000X
FLME91819207N00000X
NC2017-01169207N00000X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
No207N00000XAllopathic & Osteopathic PhysiciansDermatology