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Individual

EDWARD C WEISBERGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
705 RILEY HOSPITAL DR, SUITE 0860, INDIANAPOLIS, IN 46202-5128
(317) 948-3226
(317) 944-2443
Mailing address
250 N SHADELAND AVE, STE 130 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
01029196A
IN
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
01029196A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100062530
IN
Enumeration date
07/04/2006
Last updated
02/26/2014
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