Provider Demographics
NPI:1811456676
Name:WEECH, DAVID C (DO)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:C
Last Name:WEECH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4008 E HACKAMORE CIR
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85205-4026
Mailing Address - Country:US
Mailing Address - Phone:480-447-7274
Mailing Address - Fax:
Practice Address - Street 1:1809 E UNIVERSITY DR UNIT 101
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-8235
Practice Address - Country:US
Practice Address - Phone:480-447-7274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2023-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
AZ008755207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program