Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | ME13473 | FL |
NPI | 1003000522 |
---|---|
Provider Name | Dr. Frederick J Weigand |
First Address | Deltona, FL 32725-5823 |
Second Address | Deltona, FL 32725-5876 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2007 |
Last Update Date | 04/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D57592 | UPIN (01) | FL |