Individual
MICAH LORENZ WEIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
120 CRICKET LN, NORTH ANDOVER, MA 01845-4837
(817) 321-0404
(469) 522-6889
Mailing address
PO BOX 227143, DALLAS, TX 75222-7143
(800) 841-4236
(985) 646-0750
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
225681
NY
2085R0202X
Diagnostic Radiology Physician
Primary
M2191
TX
2085R0204X
Vascular & Interventional Radiology Physician
M2191
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11181013
CAQH
MA
Enumeration date
05/04/2006
Last updated
11/06/2025
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