# SJMH MEDICAL PRACTICE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154423598
- **Authorized official:** JACK WEINER (CEO)
- **Authorized official phone:** (248) 858-3140

## Contact information

- **Practice address:** 44405 WOODWARD AVE, PONTIAC, MI 48341-5023
- **Practice address phone:** (248) 858-3526
- **Practice address fax:** (248) 858-6232
- **Mailing address:** 44405 WOODWARD AVE, PONTIAC, MI 48341-5023
- **Mailing address phone:** (248) 858-3526
- **Mailing address fax:** (248) 858-6232

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | — | NULL | Yes |
| 2080P0204X | Pediatric Emergency Medicine (Pediatrics) Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/05/2006
- **Last updated:** 09/11/2025