MEDICARE: MICHAEL CHI-FU WENG D.C.

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	111N00000X	Chiropractor	2301009869	MI

General Provider Information

NPI Number	:	1124300942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL CHI-FU WENG D.C.

Provider Business Mailing Address
First Line	:	26421 SOUTHFIELD RD
Second Line	:
City	:	LATHRUP VILLAGE
State	:	MI
Zip	:	48076-4528
Country	:	US
Telephone Number	:	248-905-5066
Fax Number	:	248-905-5069

Provider Business Practice Location Address
First Line	:	7501 BIG BEND BLVD
Second Line	:
City	:	WEBSTER GROVES
State	:	MO
Zip	:	63119-2103
Country	:	US
Telephone Number	:	314-644-5333
Fax Number	:	314-961-8884

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

Provider Enumeration Date	:	09/19/2011
Last Update Date	:	10/07/2013

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