Provider Demographics
NPI:1770680779
Name:NATHAN WEI MD PA
Entity Type:Organization
Organization Name:NATHAN WEI MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEI
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PA
Authorized Official - Phone:301-694-5800
Mailing Address - Street 1:71 THOMAS JOHNSON DRIVE
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702
Mailing Address - Country:US
Mailing Address - Phone:301-694-5800
Mailing Address - Fax:301-694-0187
Practice Address - Street 1:71 THOMAS JOHNSON DRIVE
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702
Practice Address - Country:US
Practice Address - Phone:301-694-5800
Practice Address - Fax:301-694-0187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0026050207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0165880001Medicare NSC
MDS220Medicare PIN