Individual
DR. ANN M WEISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6052 W STATE ST, BOISE, ID 83703-2739
(208) 344-7799
(208) 344-7152
Mailing address
PO BOX 191050, BOISE, ID 83719-1050
(208) 955-6500
(208) 955-6503
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
5120620
WI
207P00000X
Emergency Medicine Physician
M-10998
ID
207Q00000X
Family Medicine Physician
Primary
M-10998
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013094820
—
WI
Enumeration date
11/01/2006
Last updated
12/21/2020
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