Individual
DR. RONALD A WEISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2 GOOD SAMARITAN WAY STE 220, MOUNT VERNON, IL 62864-2476
(618) 899-3900
Mailing address
PO BOX 955860, SAINT LOUIS, MO 63195-6971
(636) 498-5944
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
MC-1634
ID
207RC0000X
Cardiovascular Disease Physician
Primary
R7G95
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036075861
IL LICENSE
IL
01
—
060025804
RAILROAD MEDICARE
MO
05
—
206985202
—
MO
Enumeration date
05/24/2006
Last updated
09/27/2022
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