Individual
GARY A WEISER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
133 BROOKLINE AVE, INTERNAL MEDICINE, BOSTON, MA 02215-3904
(617) 421-8843
(617) 421-2040
Mailing address
147 MILK ST, PROVIDER ENROLLMENT - 9TH FLOOR, BOSTON, MA 02109-4806
(617) 559-8374
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
53106
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0014925
NEIGHBORHOOD HEALTH
MA
05
—
3192725
—
MA
01
—
729782
TUFTS
MA
01
—
J03303
BLUE CROSS
MA
01
—
M299
HARVARD PILGRIM
MA
Enumeration date
05/04/2006
Last updated
06/07/2011
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