Weidner, Mark H
Weidner, Mark H is an individual health care provider with primary practice located at 2 Broad Street Plz Broad Street Medical Group, Glens Falls NY 12801-4363. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Weidner, Mark H can be contacted via phone (518) 926-1770.Contact Information
Primary practice address
2 Broad Street Plz Broad Street Medical Group
Glens Falls NY 12801-4363
Phone: (518) 926-1770
Fax: (518) 926-1799
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | 210870 | New York |
Profile Details
| NPI number | 1972680288 |
|---|---|
| LBN Legal business name | Weidner, Mark H |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 1st, 2006 |
| Last updated | Jun 8th, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972680288 | NPPES |
| New York | MEDICAID | 01609810 | |
| New York | Other | RB8388 | |
| New York | MEDICAID | 0VN1263 |
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