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Organization
SJMH MEDICAL PRACTICE
Active
Organization
SJMH MEDICAL PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK WEINER (CEO)
(248) 858-3140
Entity
Organization
Contact information
Practice address
44405 WOODWARD AVE, PONTIAC, MI 48341-5023
(248) 858-3526
(248) 858-6232
Mailing address
44405 WOODWARD AVE, PONTIAC, MI 48341-5023
(248) 858-3526
(248) 858-6232
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
2080N0001X
Neonatal-Perinatal Medicine Physician
—
NULL
2080N0001X
Neonatal-Perinatal Medicine Physician
—
—
2080P0203X
Pediatric Critical Care Medicine Physician
—
NULL
2080P0203X
Pediatric Critical Care Medicine Physician
—
—
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
—
NULL
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
—
—
Other
Enumeration date
09/05/2006
Last updated
09/11/2025
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