Provider Demographics
NPI:1891711891
Name:WEISS, ROBERT J (DO)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:WEISS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:29 MEMORIAL MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-4407
Mailing Address - Country:US
Mailing Address - Phone:864-312-3105
Mailing Address - Fax:864-220-1888
Practice Address - Street 1:29 MEMORIAL MEDICAL DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4407
Practice Address - Country:US
Practice Address - Phone:864-220-1200
Practice Address - Fax:864-220-1888
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCDO87521207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAW9369112Medicare PIN