Basic Information
Provider Information
NPI: 1598713000
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WESTON
FirstName: MARGRETHE
MiddleName: E
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6451 N FEDERAL HWY
Address2: SUITE 800
City: FT LAUDERDALE
State: FL
PostalCode: 333081402
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 620 JOHN PAUL JONES CIR
Address2: NAVAL MEDICAL CENTER PORTSMOUTH
City: PORTSMOUTH
State: VA
PostalCode: 237082111
CountryCode: US
TelephoneNumber: 7579531407
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/05/2006
LastUpdateDate: 12/13/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000XMD445012PAY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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