Provider Demographics
NPI:1568699288
Name:WEISS, KAREN LISA (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:LISA
Last Name:WEISS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1328 CAMINO CORRALES
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-7501
Mailing Address - Country:US
Mailing Address - Phone:505-699-4664
Mailing Address - Fax:505-983-7880
Practice Address - Street 1:1328 CAMINO CORRALES
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-7501
Practice Address - Country:US
Practice Address - Phone:505-699-4664
Practice Address - Fax:505-983-7880
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-20
Last Update Date:2009-06-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NM2000-307207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology