Provider Demographics
NPI:1679643597
Name:WEISBERG, WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:WEISBERG
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 1:8 BERWYN DRIVE
Mailing Address - Street 2:
Mailing Address - City:OCEAN VIEW
Mailing Address - State:NJ
Mailing Address - Zip Code:08230
Mailing Address - Country:US
Mailing Address - Phone:609-884-4357
Mailing Address - Fax:609-884-4377
Practice Address - Street 1:900 ROUTE 109
Practice Address - Street 2:
Practice Address - City:CAPE MAY
Practice Address - State:NJ
Practice Address - Zip Code:08204
Practice Address - Country:US
Practice Address - Phone:609-884-4357
Practice Address - Fax:609-884-4377
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04603400207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE13099Medicare UPIN
583263Medicare PIN
NJ5788490001Medicare NSC