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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
44555 WOODWARD AVE, SUITE 402, PONTIAC, MI 48341-5031
(248) 335-1110
(248) 858-3999
Mailing address
44555 WOODWARD AVE, SUITE 402, PONTIAC, MI 48341-5031
(248) 335-1110
(248) 858-3999

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
207RP1001X
Pulmonary Disease Physician

Other

Enumeration date
09/05/2006
Last updated
09/11/2025
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