Provider Demographics
NPI:1780673822
Name:QUAKERTOWN INTERNAL MEDICINE ASSOCIATES, INC.
Entity Type:Organization
Organization Name:QUAKERTOWN INTERNAL MEDICINE ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:WESLEY
Authorized Official - Last Name:WEIBEL
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:215-538-1111
Mailing Address - Street 1:1021 PARK AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-1573
Mailing Address - Country:US
Mailing Address - Phone:215-538-1111
Mailing Address - Fax:215-538-2166
Practice Address - Street 1:1021 PARK AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-1573
Practice Address - Country:US
Practice Address - Phone:215-538-1111
Practice Address - Fax:215-538-2166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-20
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA=========OtherEIN