Active NPI
Gary Weber, D.O.
- Cardiovascular Disease Physician
- Grand Blanc, MI
National Provider Identifier
1811966922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 5101008355
- Practice address
- 3399 Pollock Rd
Grand Blanc, MI 48439-8393 - Phone
- (810) 603-0170
- Fax
- (810) 579-1705
- NPI assigned
- Mar 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 5101008355 | MI | Primary |
Addresses
Primary practice location
3399 Pollock Rd
Grand Blanc, MI 48439-8393
Mailing address
3399 Pollock Rd
Grand Blanc, MI 48439-8393
Phone (810) 603-0170
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3369926 | Medicaid | MI | |
| 0682500745 | Other | MI | HEALTH PLUS OF MICHIGAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101008355 | MI | MD | Cardiovascular Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464048000000",
"number": "1811966922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3399 POLLOCK RD",
"city": "GRAND BLANC",
"state": "MI",
"postal_code": "484398393",
"telephone_number": "810-603-0170",
"fax_number": "810-579-1705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3399 POLLOCK RD",
"city": "GRAND BLANC",
"state": "MI",
"postal_code": "484398393",
"telephone_number": "810-603-0170",
"fax_number": "810-579-1705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEBER",
"first_name": "GARY",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-14",
"last_updated": "2016-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "MI",
"license": "5101008355",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3369926",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PLUS OF MICHIGAN",
"identifier": "0682500745",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Blanc, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.