Active NPI
Gary L Wease MD PC
- Surgery Physician
- Flint, MI
National Provider Identifier
1164609442
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- Legal business name
- GARY L WEASE MD PC
- Practice address
- G3286 Beecher Rd
Suite E
Flint, MI 48532-3614 - Phone
- (810) 733-9760
- NPI assigned
- Jan 29, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Gary Lane Wease, MD
- Title
- President/Owner
- Phone
- (810) 733-9760
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | Primary |
Addresses
Primary practice location
G3286 Beecher Rd
Suite E
Flint, MI 48532-3614
Mailing address
PO Box 320309
Flint, MI 48532-0006
Phone (810) 733-9760
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0980253 | Other | MI | HEALTHPLUS |
| C5296 | Other | MI | MCARE PROVIDER # |
| P00096336 | Other | MI | RAILROAD MEDICARE PROV # |
| 1007216 | Other | MI | MCLAREN HEALTH PLAN |
| 103347535 | Medicaid | MI | |
| 139110 | Other | MI | GREAT LAKES HEALTH PLAN |
| 0202510241 | Other | MI | BCBSM PROVIDER # |
National Provider Directory
National Provider DirectoryLocations
G3286 Beecher Rd
Ste E
Flint, MI 48532
Phone (810) 733-9760
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201564800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1217462400000",
"number": "1164609442",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 320309",
"city": "FLINT",
"state": "MI",
"postal_code": "485320006",
"telephone_number": "810-733-9760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "G3286 BEECHER RD",
"address_2": "SUITE E",
"city": "FLINT",
"state": "MI",
"postal_code": "485323614",
"telephone_number": "810-733-9760"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GARY L WEASE MD PC",
"organizational_subpart": "NO",
"enumeration_date": "2008-01-29",
"last_updated": "2008-07-31",
"status": "A",
"authorized_official_last_name": "WEASE",
"authorized_official_first_name": "GARY",
"authorized_official_middle_name": "LANE",
"authorized_official_title_or_position": "PRESIDENT/OWNER",
"authorized_official_telephone_number": "810-733-9760",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPLUS",
"identifier": "0980253",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MCARE PROVIDER #",
"identifier": "C5296",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE PROV #",
"identifier": "P00096336",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MCLAREN HEALTH PLAN",
"identifier": "1007216",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "103347535",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GREAT LAKES HEALTH PLAN",
"identifier": "139110",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM PROVIDER #",
"identifier": "0202510241",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Flint, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.