Provider Demographics
NPI:1124008735
Name:WEYER, DARLENE DOROTHY (MD)
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:DOROTHY
Last Name:WEYER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1049
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45802-1049
Mailing Address - Country:US
Mailing Address - Phone:419-224-5707
Mailing Address - Fax:419-223-2726
Practice Address - Street 1:205 E. PALMER ROAD
Practice Address - Street 2:
Practice Address - City:BELLEFONTAINE
Practice Address - State:OH
Practice Address - Zip Code:43311-2281
Practice Address - Country:US
Practice Address - Phone:937-592-4015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.0066612085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR2182445Medicaid
KY7100171270Medicaid
OH4213453Medicare PIN
KY7100171270Medicaid
WE4213451Medicare PIN
G95935Medicare UPIN