Deric O. Weiss MD
Hospice and Palliative Medicine (Internal Medicine) Physician in Bozeman, MT(View on Map)
Full Name
Deric O. Weiss MD
NPI Number
1639252398
NPI Type
Individual Provider
Gender
Male
Enumeration Date
10/23/2006
Specialties
(Taxonomies)Code
207RH0002X
207R00000X
Primary Taxonomy
Yes
No
Licenses
State
Montana
Washington
License Number
8263
MD60406454
Contact
Information
Purpose
Mailing
Location
Address
915 HIGHLAND BLVD
937 HIGHLAND BLVD
City
Bozeman
Bozeman
State
MT
MT
Postal Code
59715-6902
59715-6909
Country
US
US
Telephone Number
(406) 414-1720
(406) 414-2400
Identifiers
Identifier
P01309234
000014401
112669500
0011237
Identifier State
WA
MT
WY
MT
Identifier Issuer
RR MEDICARE
BCBS PIN
MDCD PIN
MDCD PIN
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 03/19/2018