Provider Demographics
NPI:1316902687
Name:WEISS, MITCHELL H (MD)
Entity type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:H
Last Name:WEISS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9314 PARK WEST BLVD
Mailing Address - Street 2:# 300
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4328
Mailing Address - Country:US
Mailing Address - Phone:865-690-9475
Mailing Address - Fax:865-690-2033
Practice Address - Street 1:9314 PARK WEST BLVD
Practice Address - Street 2:# 300
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4328
Practice Address - Country:US
Practice Address - Phone:865-690-9475
Practice Address - Fax:865-690-2033
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2020-06-18
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Provider Licenses
StateLicense IDTaxonomies
TNMD38086207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3889618Medicaid
TN3889618Medicare PIN
TN3889618Medicaid