Individual
BARRY A WEISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
PMG AT 8300 CONSTITUTION - GI, 8300 CONSTITUITON AVE NE, ALBUQUERQUE, NM 87110
(505) 559-6300
(505) 559-6301
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-5356
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
84-285
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E3535
—
NM
Enumeration date
07/12/2006
Last updated
08/14/2008
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