Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 25MA02336600 | NJ |
NPI | 1265690549 |
---|---|
Provider Name | Richard Stockton Weeder |
First Address | Lawrenceville, NJ 08648-1623 |
Second Address | Lawrenceville, NJ 08648-1623 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2008 |
Last Update Date | 23/05/2008 |