Provider Demographics
NPI:1770089369
Name:WEYKAMP, MICHAEL BERNARD (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:BERNARD
Last Name:WEYKAMP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MIKE
Other - Middle Name:BERNARD
Other - Last Name:WEYKAMP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:DEPARTMENT OF SURGERY BOX 356410 1959 NE PACIFIC STREET
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:DEPARTMENT OF SURGERY 1959 NE PACIFIC STREET
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-0001
Practice Address - Country:US
Practice Address - Phone:616-283-4030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-03
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program