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Organization

WEISS PEDIATRICS PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PRABHA SWAMY WEISS MD (PHYSICIAN/OWNER)
(928) 680-1264
Entity
Organization

Contact information

Practice address
2082 MESQUITE AVE, SUITE A-102, LAKE HAVASU CITY, AZ 86403-6710
(928) 680-1264
(982) 680-1265
Mailing address
PO BOX 11123, BELFAST, ME 04915-4002
(617) 402-1000
(617) 402-1099

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Enumeration date
08/07/2012
Last updated
08/17/2012
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