Healthcare Provider Details

I. General information

NPI: 1801247200
Provider Name (Legal Business Name): JARED R WEIR, MD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2016
Last Update Date: 06/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 COOPER AVE SUITE 12
SAGINAW MI
48602-5394
US

IV. Provider business mailing address

800 COOPER AVE SUITE 12
SAGINAW MI
48602-5394
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: DR. JARED R WEIR
Title or Position: OWNER
Credential: MD
Phone: 989-754-7200