Basic Information
| Provider Information | |||||||||
| NPI: | 1356729974 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WEISE-FLECKENSTEIN | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | DANIELA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 175 S UNION BLVD STE 220 | ||||||||
| Address2: | |||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809103147 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7196341532 | ||||||||
| FaxNumber: | 7196341715 | ||||||||
| Practice Location | |||||||||
| Address1: | 175 S UNION BLVD STE 220 | ||||||||
| Address2: | |||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809103147 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7196341532 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/14/2015 | ||||||||
| LastUpdateDate: | 06/10/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/10/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207V00000X | DR.0062554 | CO | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.