Individual
DR. LEONARD J WEIRETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
825 FAIRFAX AVE, SUITE 610, NORFOLK, VA 23507-1914
(757) 446-8950
(757) 446-5197
Mailing address
PO BOX 936, NORFOLK, VA 23501-0936
(757) 446-8950
(757) 446-5197
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0101041367
VA
2086S0102X
Surgical Critical Care Physician
Primary
0101041367
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
-019
TRICARE/CHAMPUS
VA
05
—
007323905
—
VA
01
—
0572M
BC/BS
NC
01
—
081911
ANTHEM
VA
01
—
15912
SENTARA
VA
01
—
215382
UHC/MAMSI
VA
05
—
890572M
—
NC
01
—
PAR
AETNA
VA
Enumeration date
03/08/2006
Last updated
01/27/2009
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