Basic Information
| Provider Information | |||||||||
| NPI: | 1972737674 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WEITMAN | ||||||||
| FirstName: | EVAN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2727 PACES FERRY RD SE STE 1-1100 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303396151 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4702713418 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1968 PEACHTREE RD NW BLDG 775TH | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 30309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4046054600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2009 | ||||||||
| LastUpdateDate: | 08/22/2018 | ||||||||
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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 | 204F00000X | 080414 | GA | Y | Allopathic & Osteopathic Physicians | Transplant Surgery |
No ID Information.