Provider Demographics
NPI:1770576597
Name:WEYER, JANELLE L (MD)
Entity type:Individual
Prefix:
First Name:JANELLE
Middle Name:L
Last Name:WEYER
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:PO BOX 11773
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-0013
Mailing Address - Country:US
Mailing Address - Phone:480-907-7707
Mailing Address - Fax:480-907-7097
Practice Address - Street 1:3800 S ALMA SCHOOL RD
Practice Address - Street 2:SUITE 112
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85248-4499
Practice Address - Country:US
Practice Address - Phone:480-907-7707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11109215-1205207R00000X
MN64902207R00000X
AZ31826207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ31826OtherLICENSE
AZ858988Medicaid
AZ31826OtherLICENSE
I05861Medicare UPIN