Provider Demographics
NPI:1821190497
Name:WEAMER, ALAN P (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:P
Last Name:WEAMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3495 S CENTER RD
Mailing Address - Street 2:
Mailing Address - City:BURTON
Mailing Address - State:MI
Mailing Address - Zip Code:48519-1455
Mailing Address - Country:US
Mailing Address - Phone:810-424-2007
Mailing Address - Fax:810-743-1099
Practice Address - Street 1:8020 DAVISON RD
Practice Address - Street 2:
Practice Address - City:DAVISON
Practice Address - State:MI
Practice Address - Zip Code:48423-2029
Practice Address - Country:US
Practice Address - Phone:810-653-4145
Practice Address - Fax:810-653-1741
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301035257207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3235833Medicaid
MIB47374Medicare UPIN
MIM23560057Medicare PIN