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Individual

THOMAS KEITH WEIDMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
750 E ADAMS ST, SYRACUSE, NY 13210-2342
(315) 464-6202
(315) 464-9501
Mailing address
750 E ADAMS ST, SYRACUSE, NY 13210-2342
(315) 464-6202
(315) 464-9501

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
257232
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03233516
NY
Enumeration date
08/05/2008
Last updated
10/21/2010
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