Provider Demographics
NPI:1528061777
Name:WEISS, ROBERT F (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:F
Last Name:WEISS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 BROOKS LN
Mailing Address - Street 2:STE G20
Mailing Address - City:JEFFERSON HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:15025-3752
Mailing Address - Country:US
Mailing Address - Phone:412-267-5040
Mailing Address - Fax:412-384-3505
Practice Address - Street 1:1200 BROOKS LN
Practice Address - Street 2:STE G20
Practice Address - City:JEFFERSON HILLS
Practice Address - State:PA
Practice Address - Zip Code:15025-3752
Practice Address - Country:US
Practice Address - Phone:412-267-5040
Practice Address - Fax:412-384-3505
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD022138E207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01706357Medicaid
PA10397019Medicaid
PA200008973Medicare ID - Type UnspecifiedRAILROAD
PAC28303Medicare UPIN
PAWE036585Medicare ID - Type UnspecifiedINDIVIDUAL
PA01706357Medicaid
PA0584900003Medicare NSC
PA0584900001Medicare NSC