Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 204570 | MA |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 204570 | MA |
NPI | 1235197872 |
---|---|
Provider Name | Dr. Paul P Weitzel |
First Address | Waltham, MA 02451-1433 |
Second Address | Waltham, MA 02451-1433 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 20/01/2017 |