Individual
COLLEEN WESELOH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1021 BROADWAY ST, BUFFALO, NY 14212-1460
(716) 529-3020
(716) 529-3040
Mailing address
6 13TH AVE E, POLSON, MT 59860-5315
(406) 883-5680
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036142994
IL
207Q00000X
Family Medicine Physician
295871
NY
207Q00000X
Family Medicine Physician
Primary
MED-PHYS-LIC-82860
MT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/04/2014
Last updated
04/29/2021
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