Individual
DR. JOSEPH S WEISMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1225 MAPLE AVE SW, ROANOKE, VA 24016-4707
(540) 345-2020
Mailing address
1225 MAPLE AVE SW, ROANOKE, VA 24016-4707
(540) 345-2020
(540) 344-0079
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
0101048960
VA
207WX0109X
Neuro-ophthalmology Physician
Primary
0101048960
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006300944
—
VA
01
—
00X723W01
MEDICARE PTAN
—
01
—
298425
BC/BS PROVIDER ID
—
01
—
C10500
GROUP PTAN
—
Enumeration date
05/18/2006
Last updated
08/18/2020
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