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Individual

MR. MICHAEL K WEIL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
380 GATEWAY DR, SLIDELL, LA 70461-5540
(985) 690-6600
(985) 690-9860
Mailing address
PO BOX 1125, SLIDELL, LA 70459-1125
(985) 690-6600
(985) 690-9860

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
12595R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
070016132
MEDICARE RAIL ROAD
LA
05
1537811
LA
01
721481637001
TRICARE SOUTH
LA
Enumeration date
11/28/2006
Last updated
06/11/2012
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