Basic Information
| Provider Information | |||||||||
| NPI: | 1174685390 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WEIL | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | PETER | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4905 W TILGHMAN ST | ||||||||
| Address2: | SUITE 250 | ||||||||
| City: | ALLENTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 181049130 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4848669583 | ||||||||
| FaxNumber: | 6103661147 | ||||||||
| Practice Location | |||||||||
| Address1: | 4905 W TILGHMAN ST | ||||||||
| Address2: | SUITE 250 | ||||||||
| City: | ALLENTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 181049130 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4848669583 | ||||||||
| FaxNumber: | 6103661147 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/14/2006 | ||||||||
| LastUpdateDate: | 02/27/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | MD431077 | PA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 0162922 | 05 | NJ | MEDICAID | 50077669 | 01 | PA | CAPITAL ADVANTAGE | OTHER | 000000242913 | 01 | PA | UNISON | OTHER | 1021234600001 | 05 | PA | MEDICAID | 2022445 | 01 | PA | HIGHMARK | OTHER | 823147 | 01 | PA | 1ST HEALTH PRIORITY | OTHER | 119185 | 01 | PA | GEISINGER | OTHER |