Individual
VANESSA RAE WEIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3401 N BROAD ST FL 5, PHILADELPHIA, PA 19140-5103
(800) 836-7536
Mailing address
3401 N BROAD ST BLDG 5, PHILADELPHIA, PA 19140-5103
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MT238053
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
PA
Other
Enumeration date
04/10/2025
Last updated
06/09/2026
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