Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | MD027555E | PA |
NPI | 1174685762 |
---|---|
Provider Name | Dr. Susan M Weil |
First Address | Rose Valley, PA 19063-4227 |
Second Address | Chester, PA 19013-3902 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C63165 | (02) | PA |