Individual
ZACHARY WEISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1510 12TH AVE RD STE 200, NAMPA, ID 83686-6008
(208) 302-6800
(208) 302-6855
Mailing address
3340 E GOLDSTONE DR, MERIDIAN, ID 83642
(208) 302-6800
(208) 302-6855
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M-14005
ID
207Q00000X
Family Medicine Physician
MRM-1580
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1932557782
—
ID
Enumeration date
06/01/2016
Last updated
09/17/2020
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