Individual
LORI WEIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7300 N CANTON CENTER RD, SUITE 111, CANTON, MI 48187-1579
(734) 454-8001
Mailing address
7330 N CANTON CENTER RD, CANTON, MI 48187-1538
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301054209
MI
Other
Enumeration date
02/10/2006
Last updated
02/06/2014
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