Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 0101031434 | VA |
NPI | 1003816356 |
---|---|
Provider Name | Robert Weisberger |
First Address | Richmond, VA 23238-5408 |
Second Address | Richmond, VA 23226-1907 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2005 |
Last Update Date | 03/03/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B07120 | (02) | VA |