Provider Demographics
NPI:1790856854
Name:WEYER, RICHARD HELGE (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:HELGE
Last Name:WEYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-2807
Mailing Address - Country:US
Mailing Address - Phone:520-458-1787
Mailing Address - Fax:520-458-1519
Practice Address - Street 1:165 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-2807
Practice Address - Country:US
Practice Address - Phone:520-458-1787
Practice Address - Fax:520-458-1519
Is Sole Proprietor?:No
Enumeration Date:2006-11-12
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11286207NS0135X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0002206400OtherDES
AZE38622OtherSTERLING
AZ121974OtherHEALTHNET
AZ0866509OtherCIGNA
AZ4127705OtherAETNA
AZAZ0019120OtherBLUE CROSS OF AZ
AZ4127705OtherAETNA