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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
44405 WOODWARD AVE, SUITE 202, PONTIAC, MI 48341-5023
(248) 858-2270
(248) 335-6171
Mailing address
44405 WOODWARD AVE, SUITE 202, PONTIAC, MI 48341-5023
(248) 858-2270
(248) 335-6171

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
207R00000X
Internal Medicine Physician
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
207RH0003X
Hematology & Oncology Physician
207RP1001X
Pulmonary Disease Physician
207RX0202X
Medical Oncology Physician
207V00000X
Obstetrics & Gynecology Physician
208000000X
Pediatrics Physician
208100000X
Physical Medicine & Rehabilitation Physician
2086S0120X
Pediatric Surgery Physician
208M00000X
Hospitalist Physician
Primary

Other

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