Provider Demographics
NPI:1811995962
Name:WEISS, CARL BROOCK JR (MD)
Entity type:Individual
Prefix:DR
First Name:CARL
Middle Name:BROOCK
Last Name:WEISS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2775 SCHOENERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-7307
Mailing Address - Country:US
Mailing Address - Phone:610-861-8080
Mailing Address - Fax:610-807-0366
Practice Address - Street 1:2775 SCHOENERSVILLE RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-7307
Practice Address - Country:US
Practice Address - Phone:610-861-8080
Practice Address - Fax:610-807-0366
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD041232E207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
0085755000OtherKEYSTONE HEALTH EAST
0085755000OtherAMERIHEALTH
1174390OtherCIGNA HEALTHCARE
77844OtherGEISINGER HEALTH PLAN
PA0011239720001Medicaid
1553794OtherUNITED HEALTHCARE
01671101OtherCAPITAL BLUE CROSS
01671101OtherKEYSTONE HEALTH CENTRAL
162441OtherHIGHMARK BLUE SHIELD
162441OtherFIRST PRIORITY LIFE INS.
819553OtherFIRST PRIORITY HEALTH
0085755000OtherINDEPENDENCE BLUE CROSS
0091768OtherAETNA PPO
110029700OtherRAILROAD MEDICARE
328822OtherHEALTH AMERICA/HEALTH ASS
P379418OtherOXFORD HEALTH PLANS
1459543OtherPRIVATE HEALTHCARE SYSTEM
2170498OtherMAMSI
162441OtherHIGHMARK BLUE SHIELD
0085755000OtherKEYSTONE HEALTH EAST