Individual
MICHAEL CARL WEISS
Active
Individual
MICHAEL CARL WEISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01030965A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000090508
ANTHEM BLUE CROSS BLUE SH
IN
05
—
100208260A
—
IN
01
—
CA0402
RAILROAD MEDICARE
IN
Enumeration date
08/30/2006
Last updated
11/29/2012
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