Individual
MICHAEL S WEISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
703 AMERICANA BLVD, BOISE, ID 83702-6754
(208) 706-7500
(208) 706-7501
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
M5147
ID
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
M5147
ID
Other
Enumeration date
05/13/2006
Last updated
10/03/2013
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