Provider Demographics
NPI:1922847169
Name:WEI, SOPHIA (PA)
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:
Last Name:WEI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 MATEER CIR
Mailing Address - Street 2:
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-5520
Mailing Address - Country:US
Mailing Address - Phone:540-808-9131
Mailing Address - Fax:
Practice Address - Street 1:125 OLDE GREENWICH DR STE 300
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-4008
Practice Address - Country:US
Practice Address - Phone:540-374-5599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant