Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 35526 | MA |
Y | 208600000X | Surgeon | 35526 | MA |
NPI | 1023003712 |
---|---|
Provider Name | Dr. Nancy Louise Weiss |
First Address | Stanardsville, VA 22973-3756 |
Second Address | Stanardsville, VA 22973-3756 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2005 |
Last Update Date | 21/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0101239874 | VIRGINIA BOARD OF REGISTRATION IN MEDICINE (01) | VA |
B99550 | (02) | MA |