Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 35276 | CO |
N | 207VX0000X | Obstetrician | DR.0035276 | CO |
NPI | 1013958370 |
---|---|
Provider Name | Dr. Kevin Paul Weary |
First Address | Colorado Springs, CO 80923-2607 |
Second Address | Colorado Springs, CO 80923-2607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2006 |
Last Update Date | 22/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01352764 | (05) | CO |