Healthcare Provider Details

I. General information

NPI: 1285046862
Provider Name (Legal Business Name): MICHELLE JANETTE WEIL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2014
Last Update Date: 05/30/2024
Certification Date: 05/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1928 E 18TH AVE
DENVER CO
80206-1108
US

IV. Provider business mailing address

PO BOX 181742
DENVER CO
80218-8833
US

V. Phone/Fax

Practice location:
  • Phone: 303-219-1370
  • Fax: 303-225-8063
Mailing address:
  • Phone: 303-219-1370
  • Fax: 303-225-8063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberDR.0060012
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License NumberDR.0060012
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: