Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD2016-0488 | NM |
Y | 2080P0203X | Pediatric Critical Care Doctor | MD2016-0488 | NM |
NPI | 1114243144 |
---|---|
Provider Name | Thomas William Weiler |
First Address | Albuquerque, NM 87125-6666 |
Second Address | Albuquerque, NM 87106-4930 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2010 |
Last Update Date | 26/07/2016 |