Individual
JEFFREY L WEINGARTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(800) 653-6568
Mailing address
1135 W UNIVERSITY DR, STE 210, ROCHESTER HILLS, MI 48307-1872
(248) 650-4660
(248) 650-4663
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
JW402858
MI
208800000X
Urology Physician
Primary
4301402858
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2823213
—
MI
01
—
JW402858
STATE LICENSE
MI
Enumeration date
06/09/2005
Last updated
09/22/2020
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