Individual provider Active NPI

Paul Weber, DO

  • Cardiovascular Disease Physician
  • Southfield, MI
National Provider Identifier
1902547615
Registry record updated Jun 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
5101028020 Issued in MI
Practice address
22250 Providence Dr Ste 705
Southfield, MI 48075-6215
Phone
(248) 552-9858
Fax
(248) 849-9510
NPI assigned
Apr 5, 2022
Last updated
Jun 29, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 5101028020 MI Primary

Addresses

Primary practice location

22250 Providence Dr Ste 705
Southfield, MI 48075-6215

Mailing address

22250 Providence Dr Ste 705
Southfield, MI 48075-6215
Phone (248) 552-9858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220607003275 MI Order and Referring Only - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 8527446335

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101028020MIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Hospitals PastSince Apr 1, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751155200000",
    "number": "1902547615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR STE 705",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480756215",
            "telephone_number": "248-552-9858",
            "fax_number": "248-849-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR STE 705",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480756215",
            "telephone_number": "248-552-9858",
            "fax_number": "248-849-9510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBER",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-05",
        "last_updated": "2025-06-29",
        "certification_date": "2025-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "5101028020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.