Provider Demographics
NPI:1609825363
Name:STEVEN E. WEISMAN M.D., P.C.
Entity Type:Organization
Organization Name:STEVEN E. WEISMAN M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:WEISMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-551-1005
Mailing Address - Street 1:9445 E IRONWOOD SQUARE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4574
Mailing Address - Country:US
Mailing Address - Phone:480-551-1005
Mailing Address - Fax:480-513-8439
Practice Address - Street 1:9445 E IRONWOOD SQUARE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4574
Practice Address - Country:US
Practice Address - Phone:480-551-1005
Practice Address - Fax:480-513-8439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ27717207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZH05253Medicare UPIN
AZH93090Medicare UPIN
AZ67067Medicare ID - Type UnspecifiedDR. WEISMAN'S