MEDICARE: DR. DENNIS Z WEBER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	027899	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104824614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENNIS Z WEBER M.D.

Provider Business Mailing Address
First Line	:	8538 N CANTON CENTER RD
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48187-1310
Country	:	US
Telephone Number	:	734-459-1111
Fax Number	:	734-459-4307

Provider Business Practice Location Address
First Line	:	8538 N CANTON CENTER RD
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48187-1310
Country	:	US
Telephone Number	:	734-459-1111
Fax Number	:	734-459-4307

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	05/08/2014

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