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Individual

STACIE WEIL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1155 EAST MOUNTAIN BLVD., WILKES-BARRE, PA 18702
(570) 808-7916
(570) 808-6006
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
35-086657
OH
207V00000X
Obstetrics & Gynecology Physician
Primary
MD043404L
PA
207VE0102X
Reproductive Endocrinology Physician
35-086657
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000221335
UNISON
OH
01
000000509189
ANTHEM
OH
05
0014188520006
PA
05
2586652
OH
01
364121
WELLCARE
OH
01
4406587
AETNA
OH
01
751026
BUCKEYE
OH
Enumeration date
07/14/2006
Last updated
06/05/2015
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