Provider Demographics
NPI:1275705899
Name:DAVID A WEIK INC
Entity Type:Organization
Organization Name:DAVID A WEIK INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:WEIK
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:314-882-6815
Mailing Address - Street 1:419 WEBSTER FOREST DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63119-3937
Mailing Address - Country:US
Mailing Address - Phone:314-882-6815
Mailing Address - Fax:
Practice Address - Street 1:1361 BEDFORD DR
Practice Address - Street 2:SUITE 103
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-1984
Practice Address - Country:US
Practice Address - Phone:314-882-6815
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3090213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5028560001Medicare NSC