Individual
THEODORE WEISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 E LANCASTER AVE, 116 LANKENAU MEDICAL BUILDING SOUTH, WYNNEWOOD, PA 19096-3450
(610) 649-7006
Mailing address
100 E LANCASTER AVE, 116 LANKENAU MEDICAL BUILDING SOUTH, WYNNEWOOD, PA 19096-3450
(610) 649-7006
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD014735E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
736674
—
PA
Enumeration date
07/20/2006
Last updated
10/06/2017
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