Provider Demographics
NPI:1861523094
Name:WEISS, SHARON K (MED)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:K
Last Name:WEISS
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6832 OLD DOMINION DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-3887
Mailing Address - Country:US
Mailing Address - Phone:703-356-5534
Mailing Address - Fax:703-734-0910
Practice Address - Street 1:6832 OLD DOMINION DR
Practice Address - Street 2:SUITE 200
Practice Address - City:MCLEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-3887
Practice Address - Country:US
Practice Address - Phone:703-356-5534
Practice Address - Fax:703-734-0910
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist