Provider Demographics
NPI:1588988133
Name:WEISBRUCH, PAUL DAVID (MD/MBA)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:DAVID
Last Name:WEISBRUCH
Suffix:
Gender:M
Credentials:MD/MBA
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Mailing Address - Street 1:3300 GALLOWS RD
Mailing Address - Street 2:DEPT OF MEDICINE
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-3307
Mailing Address - Country:US
Mailing Address - Phone:703-776-2740
Mailing Address - Fax:703-776-3020
Practice Address - Street 1:3300 GALLOWS RD
Practice Address - Street 2:DEPT OF MEDICINE
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-3307
Practice Address - Country:US
Practice Address - Phone:703-776-2740
Practice Address - Fax:703-776-3020
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-24
Last Update Date:2016-10-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101250903207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine