Provider Demographics
NPI:1386679306
Name:WEIR, MICHELE M (MD)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:M
Last Name:WEIR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 LONGBOW PLACE
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:ON
Mailing Address - Zip Code:N6GIY3
Mailing Address - Country:CA
Mailing Address - Phone:519-685-8500
Mailing Address - Fax:
Practice Address - Street 1:LONDON HEALTH SCIENCES CENTER
Practice Address - Street 2:339 WINDERMERE ROAD
Practice Address - City:LONDON
Practice Address - State:ON
Practice Address - Zip Code:N6A5A5
Practice Address - Country:CA
Practice Address - Phone:519-685-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA81445207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology