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Individual

DIANE M WEID

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
N.P.

Contact information

Practice address
128 VAN BUREN ST, CHELSEA, MI 48118-1623
(734) 475-8677
(734) 327-0826
Mailing address
PO BOX 446, ANN ARBOR, MI 48106-0446

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
143379
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
104425850
MI
01
DW143379
BLUE SHIELD
MI
Enumeration date
06/27/2006
Last updated
01/19/2018
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