Basic Information
| Provider Information | |||||||||
| NPI: | 1801800289 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WEISSMAN | ||||||||
| FirstName: | DOUGLAS | ||||||||
| MiddleName: | MARTIN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1307 FEDERAL ST STE B100 | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152124761 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4123598900 | ||||||||
| FaxNumber: | 4123598977 | ||||||||
| Practice Location | |||||||||
| Address1: | 1307 FEDERAL ST STE B100 | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152124761 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4123598900 | ||||||||
| FaxNumber: | 4123598977 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2006 | ||||||||
| LastUpdateDate: | 10/05/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | 35.129369 | OH | N | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | 207RG0100X | 01077964A | IN | N | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | 207RG0100X | 036144304 | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | 207RG0100X | MD479317 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.