Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 5101015251 | MI |
NPI | 1063694644 |
---|---|
Provider Name | Gregory Lee Weigler |
First Address | Garden City, MI 48135 |
Second Address | Garden City, MI 48135-2538 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2007 |
Last Update Date | 05/12/2007 |