Individual
RICHARD D WEISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
230 E DAY RD, 100, MISHAWAKA, IN 46545-3408
(574) 271-3939
(574) 271-3941
Mailing address
230 E DAY RD, 100, MISHAWAKA, IN 46545-3408
(574) 271-3939
(574) 271-3941
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
01027188A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01027188A
PHYSICIAN LICENSE
IN
05
—
100222520
—
IN
01
—
P00014933
RR MEDICARE
IN
Enumeration date
12/23/2005
Last updated
03/21/2013
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