Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | MBO48543NJ | NJ |
Y | 204C00000X | Sports Medicine Doctor | OS14386 | FL |
N | 207X00000X | Orthopaedic Surgeon | OS14386 | FL |
NPI | 1871537027 |
---|---|
Provider Name | Dr. Raymond Louis Weiand |
First Address | Palm Coast, FL 32164-5999 |
Second Address | Palm Coast, FL 32164-5999 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2006 |
Last Update Date | 02/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E66616 | (02) | NJ |