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NPI Code Detail

MEDICARE: DR. RACHEL ANNE WEIR M.D.

MEDICARE: DR. RACHEL ANNE WEIR M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0804XChild & Adolescent Psychiatry Physician4977764-1205UT

General Provider Information

NPI Number : 1487779955
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RACHEL ANNE WEIR M.D.
Provider Business Mailing Address
First Line : 650 KOMAS DR STE 208
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84108-1241
Country : US
Telephone Number : 801-585-1212
Fax Number : 801-585-9096
Provider Business Practice Location Address
First Line : 650 KOMAS DR STE 208
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84108-1241
Country : US
Telephone Number : 801-585-1212
Fax Number : 801-585-9096
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2007
Last Update Date : 12/20/2021

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