Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 0101269409 | VA |
NPI | 1326492570 |
---|---|
Provider Name | Michael Lawrence Weissberger |
First Address | Richmond, VA 23227-4359 |
Second Address | Richmond, VA 23227-4359 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2016 |
Last Update Date | 04/02/2021 |