Individual
PHILIP S WEISS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 LAKE HEARN DR NE, SUITE 100, ATLANTA, GA 30342-1523
(404) 256-3178
(404) 256-3583
Mailing address
1100 LAKE HEARN DR NE, SUITE 100, ATLANTA, GA 30342-1523
(404) 256-3178
(404) 256-3583
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
038398
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040470
GREAT WEST
—
01
—
499492
BLUE CROSS BLUE SHIELD
—
01
—
5033138
AETNA CAPITATED
—
01
—
569351
AETNA
—
01
—
691304
CIGNA HEALTHCARE
—
Enumeration date
04/19/2006
Last updated
07/08/2007
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