Individual
KRISTIN ANN MARIE WEIDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
901 PATIENTS FIRST DR, WASHINGTON, MO 63090-4700
(636) 239-4100
(636) 390-4341
Mailing address
901 PATIENTS FIRST DR, WASHINGTON, MO 63090-4700
(636) 239-4100
(636) 390-4341
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2003014017
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207194408
—
MO
01
—
P00251107
RAILROAD MEDICARE
—
Enumeration date
06/16/2006
Last updated
01/23/2012
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