Provider Demographics
NPI:1760459994
Name:WEINGARDEN, SAUL ISRAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:SAUL
Middle Name:ISRAEL
Last Name:WEINGARDEN
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:20307 W. TWELVE MILE RD.
Mailing Address - Street 2:STE. 104
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-5407
Mailing Address - Country:US
Mailing Address - Phone:248-353-3388
Mailing Address - Fax:248-353-0492
Practice Address - Street 1:20307 W 12 MILE RD
Practice Address - Street 2:STE. 104
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-5407
Practice Address - Country:US
Practice Address - Phone:248-353-3388
Practice Address - Fax:248-353-0492
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-07
Last Update Date:2010-01-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI43010371162081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIA76042Medicare UPIN