| Amy R Weidman Md Llc | |
|
3610 W Market St Ste 108 Fairlawn OH 44333-9301 | |
| (330) 836-2828 | |
| (330) 836-0959 |
| Full Name | Amy R Weidman Md Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3610 W Market St, Fairlawn, Ohio |
| Authorized Official Name and Position | Amy R. Weidman (OWNER/AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 3308362828 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amy R Weidman Md Llc 3610 W Market St Ste 108 Fairlawn OH 44333-9301 Ph: (330) 836-2828 | Amy R Weidman Md Llc 3610 W Market St Ste 108 Fairlawn OH 44333-9301 Ph: (330) 836-2828 |
| NPI Number | 1770022089 |
|---|---|
| Provider Enumeration Date | 02/20/2017 |
| Last Update Date | 02/20/2017 |
| Medicare PECOS PAC ID | 5799053195 |
|---|---|
| Medicare Enrollment ID | O20170607001322 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770022089 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Amy R Weidman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235143165 PECOS PAC ID: 7214084128 Enrollment ID: I20090413000003 |
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