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Individual

SHELDON WEINER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3577 W 13 MILE RD, SUITE 204, ROYAL OAK, MI 48073-6710
(248) 551-2441
(248) 551-1094
Mailing address
29992 NORTHWESTERN HWY, SUITE C, FARMINGTON HILLS, MI 48334-3292
(248) 551-2446

Taxonomy

Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
4301039690
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
160F376970
BLUE SHIELD INDIVIDUAL
MI
05
1881654887
MI
01
700H273300
BLUE SHIELD GROUP
MI
Enumeration date
03/24/2006
Last updated
03/31/2014
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