Individual provider Active NPI

David Mark Weitzman, M.D.

  • Emergency Medicine Physician
  • North Myrtle Beach, SC
National Provider Identifier
1376776781
Registry record updated Jul 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
39135 Issued in SC
Practice address
1016 2ND Ave N Ste 203
North Myrtle Beach, SC 29582-3288
Phone
(843) 222-5395
Fax
(866) 340-0296
NPI assigned
Sep 1, 2009
Last updated
Jul 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01071702-A IN
Emergency Medicine Physician 207P00000X 71752 GA
Emergency Medicine Physician 207P00000X 39135 SC Primary
Emergency Medicine Physician 207P00000X 53530 WI
Family Medicine Physician 207Q00000X 53530 WI
Family Medicine Physician 207Q00000X 39135 SC
Family Medicine Physician 207Q00000X 71752 GA
Family Medicine Physician 207Q00000X 01071702 IN
Addiction Medicine (Family Medicine) Physician 207QA0401X 71752 GA
Addiction Medicine (Family Medicine) Physician 207QA0401X 53530 WI
Addiction Medicine (Family Medicine) Physician 207QA0401X 39135 SC
Addiction Medicine (Family Medicine) Physician 207QA0401X 01071702 IN
Aerospace Medicine Physician 2083A0100X 39135 SC
Vascular Surgery Physician 2086S0129X 71752 GA
Vascular Surgery Physician 2086S0129X 39135 SC

Addresses

Primary practice location

1016 2ND Ave N Ste 203
North Myrtle Beach, SC 29582-3288

Mailing address

4701 S Ocean Blvd Apt 5F
North Myrtle Beach, SC 29582-5367
Phone (843) 222-5395

Other practice location 1

4701 S Ocean Blvd Apt 5F
North Myrtle Beach, SC 29582-5367
Phone (843) 222-5395

Other identifiers 4

IdentifierTypeStateIssuer
01071702AOtherININ MED LICENSE
53530-20OtherWISTATE OF WISCONSIN
071752OtherGAGA MED LIC
39135OtherSCSC LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, SC, GA3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20130916000536 IN Practitioner - Internal Medicine 5890950026 Reassigns benefits to 1 organization
I20180503001065 SC Practitioner - Other (Physician)Practitioner - General PracticePractitioner - Family PracticePractitioner - Addiction MedicinePractitioner - Emergency Medicine 5890950026 Practice locations: North Myrtle Beach, SC
I20181213002356 GA Practitioner - Family PracticePractitioner - General Practice 5890950026 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01071702-AINMDEmergency Medicine Physician
01071702INMDFamily Medicine Physician
53530WIMDAddiction Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Morgan County Georgia Hospital Authority Single Specialty CurrentSince Oct 22, 2018 Accepting new patients
Expert Witness Services LLC Single Specialty CurrentSince Aug 3, 2025 Accepting new patients
Coastal House Calls Single Specialty CurrentSince Jul 23, 2018 Accepting new patients
USA Vein Clinics of Decatur LLC Single Specialty CurrentSince Dec 5, 2023 Accepting new patients
Pic Indiana PC Single Specialty CurrentSince Apr 27, 2016 Accepting new patients
Pic Wisconsin SC Single Specialty PastSince Sep 25, 2019 Accepting new patients

Locations

495 Winn Way
Ste 220
Decatur, GA 30030
Phone (404) 418-4328

1300 Ernest W Barrett Pkwy NW
Ste 230C
Kennesaw, GA 30152
Phone (678) 385-4670

771 Old Norcross Rd
Ste 340C
Lawrenceville, GA 30046
Phone (678) 273-7506

1740 Lions Club Rd
Madison, GA 30650
Phone (706) 342-1667

924 W Pike St
Goshen, IN 46526
Phone (574) 312-7056

505 W Cleveland Rd
Mishawaka, IN 46545
Phone (574) 235-3135

1313 W McGalliard Rd
Muncie, IN 47303
Phone (765) 216-3115

1991 Glenns Bay Rd
Ste 102B
Myrtle Beach, SC 29575
Phone (843) 410-0330

1016 2nd Ave N
Ste 203
North Myrtle Beach, SC 29582
Phone (843) 222-5395

802 41st Ave S
North Myrtle Beach, SC 29582
Phone (843) 491-3007

802 41st Ave S
Ste 101
North Myrtle Beach, SC 29582
Phone (843) 491-3007

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1251763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784073600000",
    "number": "1376776781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 S OCEAN BLVD APT 5F",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295825367",
            "telephone_number": "843-222-5395",
            "fax_number": "866-340-0296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 2ND AVE N STE 203",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295823288",
            "telephone_number": "843-222-5395",
            "fax_number": "866-340-0296"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4701 S Ocean Blvd Apt 5F",
            "address_purpose": "LOCATION",
            "city": "North Myrtle Beach",
            "state": "SC",
            "postal_code": "295825367",
            "country_code": "US",
            "telephone_number": "843-222-5395",
            "fax_number": "866-340-0296",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEITZMAN",
        "first_name": "DAVID",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-01",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01071702-A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "71752",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "39135",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "53530",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "53530",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "39135",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "71752",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01071702",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "GA",
            "license": "71752",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "WI",
            "license": "53530",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "SC",
            "license": "39135",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "IN",
            "license": "01071702",
            "primary": false
        },
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "SC",
            "license": "39135",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "GA",
            "license": "71752",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "SC",
            "license": "39135",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IN MED LICENSE",
            "identifier": "01071702A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF WISCONSIN",
            "identifier": "53530-20",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA MED LIC",
            "identifier": "071752",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC LICENSE",
            "identifier": "39135",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.