Provider Demographics
NPI:1609937564
Name:WEIGEL, JOHN HEBNER (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:HEBNER
Last Name:WEIGEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:985 PRINCE FREDERICK BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-3492
Mailing Address - Country:US
Mailing Address - Phone:410-535-2005
Mailing Address - Fax:410-535-4850
Practice Address - Street 1:985 N. PRINCE FREDERICK BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-3492
Practice Address - Country:US
Practice Address - Phone:410-535-2005
Practice Address - Fax:410-535-4850
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD26358207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD110032504OtherRAILROAD MEDICARE
MD326961200Medicaid
MD2148224OtherAETNA PCP HMO
MD836795OtherOPTIMUM CH-MDIPA
MD42249801OtherCAREFIRST OF MD
MD4461101OtherAETNA NON HMO
DCC0410007OtherCAREFIRST OF DC
MD110032504OtherRAILROAD MEDICARE
MD326961200Medicaid