Provider Demographics
NPI:1891785440
Name:WEIL, ERIC M (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:M
Last Name:WEIL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:781-485-6316
Mailing Address - Fax:781-485-6391
Practice Address - Street 1:300 OCEAN AVE
Practice Address - Street 2:RHC REVERE HEALTHCARE CENTER
Practice Address - City:REVERE
Practice Address - State:MA
Practice Address - Zip Code:02151-3675
Practice Address - Country:US
Practice Address - Phone:781-485-6316
Practice Address - Fax:781-485-6391
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2021-03-23
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Provider Licenses
StateLicense IDTaxonomies
NY306978207R00000X
MA157707207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3193365Medicaid
MAJ21033OtherBCBS MA
MA157707OtherTUFTS HEALTH PLAN
MA3193365Medicaid
MA157707OtherTUFTS HEALTH PLAN