Provider Demographics
NPI:1811967672
Name:WEIS, DANIEL RICHARD (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:RICHARD
Last Name:WEIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1490 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-3305
Mailing Address - Country:US
Mailing Address - Phone:513-881-7189
Mailing Address - Fax:513-881-7188
Practice Address - Street 1:1131 MANCHESTER AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45042-1925
Practice Address - Country:US
Practice Address - Phone:513-422-7016
Practice Address - Fax:513-422-5263
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.0987302084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry