Provider Demographics
NPI:1104824614
Name:WEBER, DENNIS Z (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:Z
Last Name:WEBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8538 N CANTON CENTER RD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-1310
Mailing Address - Country:US
Mailing Address - Phone:734-459-1111
Mailing Address - Fax:734-459-4307
Practice Address - Street 1:8538 N CANTON CENTER RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-1310
Practice Address - Country:US
Practice Address - Phone:734-459-1111
Practice Address - Fax:734-459-4307
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-08
Last Update Date:2014-05-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI027899207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1815997Medicaid
MI0486090001Medicare NSC
MI1815997Medicaid
MI0P48050Medicare PIN
MI180043621Medicare PIN