Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 0101271245 | VA |
N | 208G00000X | Cardiothoracic Vascular Surgeon | 43629 | CO |
NPI | 1073607305 |
---|---|
Provider Name | Michael J Weyant |
First Address | Baltimore, MD 21297-3174 |
Second Address | Falls Church, VA 22042-3307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 17/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
70727724 | (05) | CO |