Provider Demographics
NPI:1952379679
Name:WEIGAND, ROBERT T (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:T
Last Name:WEIGAND
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:902 N RIVERSIDE RD
Mailing Address - Street 2:STE 200
Mailing Address - City:ST JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64507-2559
Mailing Address - Country:US
Mailing Address - Phone:816-271-1301
Mailing Address - Fax:816-271-1302
Practice Address - Street 1:902 N RIVERSIDE RD
Practice Address - Street 2:STE 200
Practice Address - City:ST JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64507-2559
Practice Address - Country:US
Practice Address - Phone:816-271-1301
Practice Address - Fax:816-271-1302
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2017-10-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY19283207RX0202X
MOR1H74207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOP00859663OtherRR MEDICARE
KS613952OtherBCBS OF KS FOR MO LOCATIO
KS100113510BMedicaid
MO13452010OtherBLUE CROSS BLUE SHIELD
MO1952379679Medicaid
KS100113510BMedicaid
C51582Medicare UPIN