Individual
DR. BRIAN PAUL WEISMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10220 WICKER AVE, STE A, ST JOHN, IN 46373-9439
(219) 365-3900
(219) 365-5874
Mailing address
10220 WICKER AVE, STE A, ST JOHN, IN 46373-9439
(219) 365-3900
(219) 365-5874
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
01046205A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000199317
BCBS
IN
05
—
200123550B
—
IN
Enumeration date
09/01/2005
Last updated
09/21/2012
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