Provider Demographics
NPI:1659340420
Name:LI, WEIYE (MD)
Entity Type:Individual
Prefix:
First Name:WEIYE
Middle Name:
Last Name:LI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1740 SOUTH ST STE 400
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-1514
Mailing Address - Country:US
Mailing Address - Phone:267-607-6888
Mailing Address - Fax:267-393-4310
Practice Address - Street 1:1740 SOUTH ST STE 400
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19146-1514
Practice Address - Country:US
Practice Address - Phone:267-607-6888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD420302207W00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA10729OtherELDER HEALTH
PA1466302OtherBLUE CROSS BLUE SHIELD
PA21505410000OtherKEYSTONE INDIVIDULE
PAX002529001OtherAMERICHOICE
PA3143519OtherAETNA US HEALTHCARE INDIV
PA7001998OtherCIGNA
PA300107760OtherKEYSTONE MERCY HEALTH PLA
PA1008200730003Medicaid
PAA19503OtherAMERIHEALTH
PA0794182000OtherKEYSTONE GROUP
DE1000033580Medicaid
DE1466302OtherDELAWARE BLUE CROSS BLUE
PA31188OtherAETNA US HEALTHCARE GROUP
PA37992OtherHEALTH PARTNERS
PA37992OtherHEALTH PARTNERS
PA1008200730003Medicaid
PA1008200730003Medicaid