Healthcare Provider Details

I. General information

NPI: 1275500134
Provider Name (Legal Business Name): DAVID S. WEINGARDEN, M.D. & ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 11/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43555 DALCOMA DR SUITE 4
CLINTON TOWNSHIP MI
48038-6310
US

IV. Provider business mailing address

43555 DALCOMA DR SUITE 4
CLINTON TOWNSHIP MI
48038-6310
US

V. Phone/Fax

Practice location:
  • Phone: 586-228-2882
  • Fax: 586-463-7152
Mailing address:
  • Phone: 586-228-2882
  • Fax: 586-463-7152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2081P0010X
TaxonomyPediatric Rehabilitation Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID S WEINGARDEN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 586-228-2882