Individual
DR. MARISSA COPAS WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
640 FLORMANN ST, RAPID CITY, SD 57701-4679
(605) 755-3300
Mailing address
640 FLORMANN ST, RAPID CITY, SD 57701-4679
(605) 755-3300
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
17712
SD
208000000X
Pediatrics Physician
17712
SD
208000000X
Pediatrics Physician
Primary
94-10676
KS
Other
Enumeration date
06/08/2021
Last updated
04/03/2026
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