Provider Demographics
NPI:1003050360
Name:WEIGER, VICTORIA M (IDMT)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:M
Last Name:WEIGER
Suffix:
Gender:F
Credentials:IDMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6475 WARRIOR WAY
Mailing Address - Street 2:729 ACS/SG
Mailing Address - City:HILL AFB
Mailing Address - State:UT
Mailing Address - Zip Code:84056-5961
Mailing Address - Country:US
Mailing Address - Phone:801-777-0658
Mailing Address - Fax:
Practice Address - Street 1:6475 WARRIOR WAY
Practice Address - Street 2:729 ACS/SG
Practice Address - City:HILL AFB
Practice Address - State:UT
Practice Address - Zip Code:84056-5961
Practice Address - Country:US
Practice Address - Phone:801-777-0658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-29
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians