Provider Demographics
NPI:1538260476
Name:WEISZ, NICOLAE (MD)
Entity type:Individual
Prefix:
First Name:NICOLAE
Middle Name:
Last Name:WEISZ
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:PO BOX 371323
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89137-1323
Mailing Address - Country:US
Mailing Address - Phone:702-804-1818
Mailing Address - Fax:702-804-1720
Practice Address - Street 1:7150 SMOKE RANCH RD STE 110
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-3157
Practice Address - Country:US
Practice Address - Phone:702-804-1818
Practice Address - Fax:702-804-1720
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10894207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100503445Medicaid
NV100503445Medicaid