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Individual

BRIAN C WEITZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
15650 CEDAR AVE, APPLE VALLEY, MN 55124-7283
(952) 997-4100
Mailing address
15650 CEDAR AVE, APPLE VALLEY, MN 55124-7283
(952) 997-4100

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
52906
MN
207Q00000X
Family Medicine Physician
5307
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0100045
MT
Enumeration date
08/03/2005
Last updated
06/22/2012
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