Individual
DR. WEEZA MATTHIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
78 RIDGEWOOD DR, BANGOR, ME 04401-2652
(207) 947-0768
(207) 945-9705
Mailing address
78 RIDGEWOOD DR, BANGOR, ME 04401-2652
(207) 947-0768
(207) 945-9705
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
016622
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
047654
ANTHEM STAR NUMBER
ME
01
—
P00152138
RAILROAD MEDICARE
ME
Enumeration date
06/21/2005
Last updated
07/08/2007
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