Individual
DR. LAWRENCE I WEINER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
202 INDIAN CREEK RD, HAILEY, ID 83333
(208) 622-2775
Mailing address
PO BOX 3845, HAILEY, ID 83333
(208) 622-2775
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
M7132
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M7132
LICENSE NUMBER
ID
Enumeration date
05/02/2007
Last updated
03/07/2023
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