Basic Information
| Provider Information | |||||||||
| NPI: | 1811967672 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WEIS | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | RICHARD | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1490 UNIVERSITY BLVD | ||||||||
| Address2: | |||||||||
| City: | HAMILTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 450113305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5138817189 | ||||||||
| FaxNumber: | 5138817188 | ||||||||
| Practice Location | |||||||||
| Address1: | 1131 MANCHESTER AVE | ||||||||
| Address2: | |||||||||
| City: | MIDDLETOWN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 450421925 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5134227016 | ||||||||
| FaxNumber: | 5134225263 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/25/2006 | ||||||||
| LastUpdateDate: | 11/19/2014 | ||||||||
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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 | 2084P0804X | 35.098730 | OH | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry |
No ID Information.