Provider Demographics
NPI:1275500134
Name:DAVID S. WEINGARDEN, M.D. & ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:DAVID S. WEINGARDEN, M.D. & ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:S
Authorized Official - Last Name:WEINGARDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-228-2882
Mailing Address - Street 1:43555 DALCOMA DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-6310
Mailing Address - Country:US
Mailing Address - Phone:586-228-2882
Mailing Address - Fax:586-463-7152
Practice Address - Street 1:43555 DALCOMA DR
Practice Address - Street 2:SUITE 4
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-6310
Practice Address - Country:US
Practice Address - Phone:586-228-2882
Practice Address - Fax:586-463-7152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-28
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
No2081P0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPediatric Rehabilitation MedicineGroup - Single Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI250E01065OtherBCBS COMMON PROVIDER CODE
MI0E06114Medicare ID - Type UnspecifiedCOMMON PROVIDER CODE