Individual
EDWARD S WEISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11125 DUNN RD, SUITE 204, SAINT LOUIS, MO 63136-6132
(314) 839-5522
(314) 839-5351
Mailing address
11125 DUNN RD, SUITE 204, SAINT LOUIS, MO 63136-6132
(314) 839-5522
(314) 839-5351
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
036043458
IL
207RC0000X
Cardiovascular Disease Physician
Primary
R4677
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000011832
ESSENCE
—
01
—
060031058
MORRMCR
MO
01
—
060067878
ILRRMCR
IL
01
—
10025V8816
HCUSA
—
01
—
119140
HLNK
—
05
—
200347508
—
MO
01
—
21785
MOBS/BLCHOICE
—
01
—
2248981
CIGNA
—
01
—
2500095
UHC
—
01
—
4001174
AETNA
—
01
—
42988V30946
HLTHPART
—
01
—
431098908
TRICARE
—
01
—
5914V3831
GHP/CMR
—
01
—
A12743
MERCY
—
Enumeration date
08/25/2005
Last updated
10/28/2020
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