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Individual

WILLIAM JAY WEADOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109-5000
(734) 936-4000
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299

Taxonomy

Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
4301069519
MI
2085R0202X
Diagnostic Radiology Physician
4301069519
FM
2085R0202X
Diagnostic Radiology Physician
Primary
4301069519
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3368007
MI
Enumeration date
08/01/2006
Last updated
06/28/2019
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