Provider Demographics
NPI:1679650436
Name:WEILAND, DANIEL MARK (PA-C, MMSC, MS)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:MARK
Last Name:WEILAND
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Gender:M
Credentials:PA-C, MMSC, MS
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Mailing Address - Street 1:EMORY UNIVERSITY HOSPITAL
Mailing Address - Street 2:1365 CLIFTON ROAD
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-0001
Mailing Address - Country:US
Mailing Address - Phone:404-821-7273
Mailing Address - Fax:
Practice Address - Street 1:2500 NE NEFF RD
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-6015
Practice Address - Country:US
Practice Address - Phone:541-388-4333
Practice Address - Fax:541-388-3446
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2020-05-29
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Provider Licenses
StateLicense IDTaxonomies
GA004749363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical