Healthcare Provider Details

I. General information

NPI: 1346535655
Provider Name (Legal Business Name): JARED R WEIR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2011
Last Update Date: 03/31/2021
Certification Date: 03/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 COOPER AVE SUITE 12
SAGINAW MI
48602
US

IV. Provider business mailing address

800 COOPER AVE. SUITE 12
SAGINAW MI
48602
US

V. Phone/Fax

Practice location:
  • Phone: 989-754-7200
  • Fax: 989-754-2086
Mailing address:
  • Phone: 989-754-7200
  • Fax: 989-754-2086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number4301098815
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: