MEDICARE: DR. ALEXANDER WEICK 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	207RG0100X	Gastroenterology Physician	MD27295	ME
2	207RG0100X	Gastroenterology Physician	4301116862	MI

General Provider Information

NPI Number	:	1942542444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEXANDER WEICK M.D.

Provider Business Mailing Address
First Line	:	1105 SIXTH ST
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49684-2345
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4100 PARK FOREST DR STE 208
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49684-7306
Country	:	US
Telephone Number	:	231-935-5710
Fax Number	:	231-935-9045

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

Provider Enumeration Date	:	03/22/2013
Last Update Date	:	04/13/2024

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Directions to “ DR. ALEXANDER WEICK M.D.” Practice Location

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