Provider Demographics
NPI:1457791501
Name:DENNIS E. WEILAND, MD, PC
Entity Type:Organization
Organization Name:DENNIS E. WEILAND, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:WEILAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:489-767-6652
Mailing Address - Street 1:11779 N 114TH WAY
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85259-2607
Mailing Address - Country:US
Mailing Address - Phone:480-767-6652
Mailing Address - Fax:480-767-6652
Practice Address - Street 1:11779 N 114TH WAY
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85259-2607
Practice Address - Country:US
Practice Address - Phone:480-767-6652
Practice Address - Fax:480-767-6652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-02
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4749208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty