Individual
LARRY W WEISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
208 E CHURCH ST, SUITE 102, MARSHALLTOWN, IA 50158-2961
(641) 752-9538
(641) 753-2190
Mailing address
208 E CHURCH ST, SUITE 102, MARSHALLTOWN, IA 50158-2961
(641) 752-9538
(641) 753-2190
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
20021
IA
207NP0225X
Pediatric Dermatology Physician
20021
IA
207NS0135X
Procedural Dermatology Physician
20021
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0123562
—
IA
Enumeration date
08/07/2006
Last updated
10/01/2007
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