Provider Demographics
NPI:1801800289
Name:WEISSMAN, DOUGLAS MARTIN (MD)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:MARTIN
Last Name:WEISSMAN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 DEEPWOOD CT
Mailing Address - Street 2:2757 NORTHPOINT PKWY
Mailing Address - City:OLD WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11568
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1307 FEDERAL ST STE B100
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4761
Practice Address - Country:US
Practice Address - Phone:412-359-8900
Practice Address - Fax:412-359-8977
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04832600207RG0100X
PAMD479317207RG0100X
OH35.129369207RG0100X
WI3872207RG0100X
IN01077964A207RG0100X
IL036144304207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100265946Medicaid
FL051760700Medicaid
P225537OtherOXFORD
FL205412OtherAVMED
2400128OtherGHI
FL002940OtherNEIGHBORHOOD HEALTH
0404830OtherUNITEDHEALTHCARE
FL09940OtherBLUE CROSS BLUE SHIELD
FL110128064OtherRAILROAD MEDICARE
437797OtherHUMANA
1017292OtherCAREPLUS
0404830OtherUNITEDHEALTHCARE