Provider Demographics
NPI:1417122573
Name:MARC WEITZMAN,DPM PC
Entity Type:Organization
Organization Name:MARC WEITZMAN,DPM PC
Other - Org Name:A-PLUS FOOTCARE OF ROYAL OAK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:WEITZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:248-547-1020
Mailing Address - Street 1:1010 N CAMPBELL RD
Mailing Address - Street 2:2
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-1570
Mailing Address - Country:US
Mailing Address - Phone:248-547-1020
Mailing Address - Fax:248-547-7066
Practice Address - Street 1:1010 N CAMPBELL RD
Practice Address - Street 2:2
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-1570
Practice Address - Country:US
Practice Address - Phone:248-547-1020
Practice Address - Fax:248-547-7066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI000907213ES0131X, 261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
No261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatricGroup - Single Specialty