Provider Demographics
NPI:1801860846
Name:WEYHRICH, DARIN LEE (MD)
Entity Type:Individual
Prefix:
First Name:DARIN
Middle Name:LEE
Last Name:WEYHRICH
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 1:222 N 2ND ST STE 206
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-6130
Mailing Address - Country:US
Mailing Address - Phone:208-342-2516
Mailing Address - Fax:208-342-1661
Practice Address - Street 1:222 N 2ND ST STE 206
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-6130
Practice Address - Country:US
Practice Address - Phone:208-342-2516
Practice Address - Fax:208-342-1661
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM8503207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID50112OtherBLUE CROSS OF IDAHO
ID806431500Medicaid
IDCS9457OtherIDAHO CONTROLLED SUBSTANC
ID000010139641OtherREGENCE BLUE SHIELD
ID13D0521509OtherCLIA LAB ID NUMBER
IDM-8503OtherSTATE LISCENSE
IDM-8503OtherSTATE LISCENSE
ID50112OtherBLUE CROSS OF IDAHO
ID1105876Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER