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General NPI Number Information
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NPI Number | 1922534031
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Entity Type | Individual
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Provider Name | DEAN M WEICH JR. DO
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Gender | Male
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Dates
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Enumeration Date | 05/10/2017
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Last Update Date | 11/23/2022
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Provider Practice Location Address
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Address Line | 36500 AURORA DR
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City | SUMMIT
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State | WI
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Zip | 53066-4899
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Country | US
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Telephone | 262-434-1000
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Fax | 262-434-5050
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Provider Business Mailing Address
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Address Line | 3301 W FOREST HOME AVE
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City | MILWAUKEE
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State | WI
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Zip | 53215-2843
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Country | US
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Telephone | 262-434-1000
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Fax | 262-434-5050
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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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 71859
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 40700
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 71859
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License Number State | WI
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