Individual
DR. JEROME P WIATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
17877 W 14 MILE RD, BEVERLY HILLS, MI 48025-3127
(248) 644-3920
(248) 644-2569
Mailing address
17877 W 14 MILE RD, BEVERLY HILLS, MI 48025-3127
(248) 644-3920
(248) 644-2569
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4301028424
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1358914
—
MI
Enumeration date
11/16/2005
Last updated
12/23/2016
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