Healthcare Provider Details

I. General information

NPI: 1922914035
Provider Name (Legal Business Name): BRETT WEINER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3950 INTERPARK DR
COLORADO SPRINGS CO
80907-5066
US

IV. Provider business mailing address

804 SIRIUS DR
COLORADO SPRINGS CO
80905-7208
US

V. Phone/Fax

Practice location:
  • Phone: 719-635-9400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number55635
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: