Provider Demographics
NPI:1821097817
Name:WEED, KAREN (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:
Last Name:WEED
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 1:1220 S ATLANTIC ST
Mailing Address - Street 2:
Mailing Address - City:DILLON
Mailing Address - State:MT
Mailing Address - Zip Code:59725-3508
Mailing Address - Country:US
Mailing Address - Phone:406-683-1188
Mailing Address - Fax:406-683-6891
Practice Address - Street 1:1220 S ATLANTIC ST
Practice Address - Street 2:
Practice Address - City:DILLON
Practice Address - State:MT
Practice Address - Zip Code:59725-3508
Practice Address - Country:US
Practice Address - Phone:406-683-1188
Practice Address - Fax:406-683-6891
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT6947207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT94135OtherBCBS PROVIDER NUMBER
MT0061412Medicaid
MTP00033868OtherRAILROAD MEDICARE PROVIDE
MT0061412Medicaid