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Individual

ROBERT ALLAN WEITZEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
78 U ST, SALT LAKE CITY, UT 84103-4304
(214) 693-2029
Mailing address
78 U ST, SALT LAKE CITY, UT 84103-4304
(214) 693-2029

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
187798-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
U000079907
PTAN
UT
Enumeration date
11/21/2011
Last updated
11/27/2017
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