Provider Demographics
NPI:1649405028
Name:YAN, WEISI (MD)
Entity type:Individual
Prefix:DR
First Name:WEISI
Middle Name:
Last Name:YAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 S 54TH ST
Mailing Address - Street 2:STE 186
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19143-1900
Mailing Address - Country:US
Mailing Address - Phone:215-748-9360
Mailing Address - Fax:
Practice Address - Street 1:800 ROSE ST STE C114D
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-8426
Practice Address - Country:US
Practice Address - Phone:859-257-7618
Practice Address - Fax:859-257-4060
Is Sole Proprietor?:No
Enumeration Date:2009-05-28
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY26288412085R0001X
TXU31342085R0001X
PAMD4642622085R0001X
AL327172085R0001X
KY547912085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology