Individual
JUSTIN WEIRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2512 E DUPONT RD STE 200, FORT WAYNE, IN 46825-1609
(260) 458-3760
(260) 458-3761
Mailing address
6920 POINTE INVERNESS WAY STE 200, FORT WAYNE, IN 46804-7934
(260) 479-3516
(260) 479-3520
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02005201A
IN
207Q00000X
Family Medicine Physician
11018859A
IN
Other
Enumeration date
06/03/2016
Last updated
12/21/2020
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