Provider Demographics
NPI:1720038656
Name:WEISMAN, STEVEN EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:EDWARD
Last Name:WEISMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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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
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ27717207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ67067Medicare ID - Type Unspecified
AZH05253Medicare UPIN