Provider Demographics
NPI:1881683217
Name:WEED, ALBERT CHARLES III (MD)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:CHARLES
Last Name:WEED
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1970 ROANOKE BLVD
Mailing Address - Street 2:SALEM VAMC (112)
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153
Mailing Address - Country:US
Mailing Address - Phone:540-982-2463
Mailing Address - Fax:540-983-1090
Practice Address - Street 1:1970 ROANOKE BLVD
Practice Address - Street 2:SALEM VAMC (112)
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153
Practice Address - Country:US
Practice Address - Phone:540-982-2463
Practice Address - Fax:540-983-1090
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101226958208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1881683217Medicaid
VA1030600100OtherMEDICARE
VA1030600100OtherMEDICARE
VA1881683217Medicaid