Provider Demographics
NPI:1689669178
Name:WEIR, JAMES ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ROBERT
Last Name:WEIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 COOPER AVE.
Mailing Address - Street 2:SUITE 12
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-5394
Mailing Address - Country:US
Mailing Address - Phone:989-754-7200
Mailing Address - Fax:989-754-2086
Practice Address - Street 1:800 COOPER AVE.
Practice Address - Street 2:SUITE 12
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-5394
Practice Address - Country:US
Practice Address - Phone:989-754-7200
Practice Address - Fax:989-754-2086
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-12
Last Update Date:2021-03-31
Deactivation Date:2006-03-22
Deactivation Code:
Reactivation Date:2006-04-05
Provider Licenses
StateLicense IDTaxonomies
MIJW050199207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1807968Medicaid
MI1807968Medicaid
MIA76909Medicare UPIN