MEDICARE: MICHAEL J WERTHEIMER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MW042891	MI

General Provider Information

NPI Number	:	1306858824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL J WERTHEIMER MD

Provider Business Mailing Address
First Line	:	2812 W CADILLAC DR
Second Line	:
City	:	FARWELL
State	:	MI
Zip	:	48622-9757
Country	:	US
Telephone Number	:	989-588-5050
Fax Number	:	989-588-5052

Provider Business Practice Location Address
First Line	:	2812 W CADILLAC DR
Second Line	:
City	:	FARWELL
State	:	MI
Zip	:	48622-9757
Country	:	US
Telephone Number	:	989-588-5050
Fax Number	:	989-588-5052

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/13/2006
Last Update Date	:	09/23/2016

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