Individual
LARRY WEISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
17421 GREENFIELD, DETROIT, MI 48235
(313) 273-7091
(313) 273-7694
Mailing address
17421 GREENFIELD RD, DETROIT, MI 48235-3700
(313) 273-7091
(313) 273-7694
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
382244642
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1485013
—
MI
01
—
382244642
TAX ID
MI
Enumeration date
07/10/2006
Last updated
02/12/2010
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