Individual
MRS. SALLY ROSE WEISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
700 MT HOPE AVE, SUITE 600, BANGOR, ME 04401-5600
(207) 947-2591
(207) 947-2591
Mailing address
700 MT HOPE AVE, SUITE 600, BANGOR, ME 04401-5600
(207) 947-2591
(207) 947-2591
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
10694
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003400
ANTHEM BCBS
ME
Enumeration date
11/16/2006
Last updated
07/08/2007
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