Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 4228 | AZ |
NPI | 1508111048 |
---|---|
Provider Name | Dr. Burton E Weissman |
First Address | Paradise Valley, AZ 85253-3414 |
Second Address | Paradise Valley, AZ 85253-3414 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2012 |
Last Update Date | 20/07/2012 |