# SJMH MEDICAL PRACTICE

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

## Provider details

- **NPI number:** 1639271075
- **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) 858-3532
- **Practice address fax:** (248) 858-6232
- **Mailing address:** 44428 WOODWARD AVE, LOWER LEVEL, PONTIAC, MI 48341-5009
- **Mailing address phone:** (248) 858-6144
- **Mailing address fax:** (248) 858-6232

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |
| 363LN0000X | Neonatal Nurse Practitioner | — | NULL | — |
| 363LN0000X | Neonatal Nurse Practitioner | — | — | — |

## Other

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