Basic Information
| Provider Information | |||||||||
| NPI: | 1841228772 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WEIL | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | CHARLES | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | WEIL | ||||||||
| OtherFirstName: | DAVID | ||||||||
| OtherMiddleName: | C | ||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1087 DENNISON AVE | ||||||||
| Address2: | STE 7 | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432013201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6144592906 | ||||||||
| FaxNumber: | 6144592932 | ||||||||
| Practice Location | |||||||||
| Address1: | 3823 TRUEMAN CT | ||||||||
| Address2: | |||||||||
| City: | HILLIARD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430262496 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6148769558 | ||||||||
| FaxNumber: | 6148769590 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2006 | ||||||||
| LastUpdateDate: | 01/25/2022 | ||||||||
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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 | 207Q00000X | 35.071801 | OH | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 2137600 | 05 | OH | MEDICAID | 000000299731 | 01 | OH | ANTHEM BC/BS | OTHER | 1844946 | 01 | OH | UNITED HEALTHCARE OF OHIO | OTHER |