Provider Demographics
NPI:1164789715
Name:WEEMAN, GLENDA CHERYL (DO)
Entity Type:Individual
Prefix:DR
First Name:GLENDA
Middle Name:CHERYL
Last Name:WEEMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2130 MOUNTAIN VIEW AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-3177
Mailing Address - Country:US
Mailing Address - Phone:303-776-8847
Mailing Address - Fax:303-776-8897
Practice Address - Street 1:2130 MOUNTAIN VIEW AVE STE 203
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-3177
Practice Address - Country:US
Practice Address - Phone:303-776-8847
Practice Address - Fax:303-776-8897
Is Sole Proprietor?:No
Enumeration Date:2012-04-20
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO50861207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine