Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 01029196A | IN |
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 01029196A | IN |
NPI | 1649200866 |
---|---|
Provider Name | Edward C Weisberger |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Indianapolis, IN 46202-5128 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2006 |
Last Update Date | 26/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100062530 | (05) | IN |
D94511 | (02) | IN |