Basic Information
| Provider Information | |||||||||
| NPI: | 1700872157 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WEISER | ||||||||
| FirstName: | HARRY | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 345 OSPREY RIDGE CT | ||||||||
| Address2: | |||||||||
| City: | ALBANY | ||||||||
| State: | GA | ||||||||
| PostalCode: | 317219400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3346981052 | ||||||||
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| Practice Location | |||||||||
| Address1: | 700 1ST AVE S | ||||||||
| Address2: | |||||||||
| City: | FARGO | ||||||||
| State: | ND | ||||||||
| PostalCode: | 581031802 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7012344036 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2005 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | 20126 | MS | N | Allopathic & Osteopathic Physicians | Neurological Surgery | 207T00000X | 14795 | ND | Y | Allopathic & Osteopathic Physicians | Neurological Surgery | 207T00000X | 039979 | GA | N | Allopathic & Osteopathic Physicians | Neurological Surgery | 207T00000X | MD31203 | AL | N | Allopathic & Osteopathic Physicians | Neurological Surgery | 207T00000X | ME 117364 | FL | N | Allopathic & Osteopathic Physicians | Neurological Surgery |
ID Information
| ID | Type | State | Issuer | Description | 000649888D | 05 | GA | MEDICAID | P00358730 | 01 | GA | RR MEDICARE | OTHER |