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General NPI Number Information
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NPI Number | 1790868198
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Entity Type | Individual
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Provider Name | ANTHONY WEINERT DPM
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Gender | Male
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 05/16/2012
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Provider Practice Location Address
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Address Line | 3272 E 12 MILE RD SUITE 101
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City | WARREN
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State | MI
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Zip | 48092-5622
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Country | US
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Telephone | 586-751-3338
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Fax |
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Provider Business Mailing Address
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Address Line | 3272 E. 12 MILE RD. SUITE 101
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City | WARREN
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State | MI
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Zip | 48092
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Country | UM
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Telephone | 586-751-3338
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 5901001964
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 5901001964
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License Number State | MI
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