Weaver, Mitchell Ross

Weaver, Mitchell Ross is an individual health care provider with primary practice located at 2799 W Grand Blvd , Detroit MI 48202-2608. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Weaver, Mitchell Ross can be contacted via phone (313) 916-3156.

Contact Information

Primary practice address
2799 W Grand Blvd Detroit MI 48202-2608
Phone: (313) 916-3156
Fax: (313) 916-3023
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 35-084264 Ohio
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 4301069776 Michigan

Profile Details

NPI number 1033191994
LBN Legal business name Weaver, Mitchell Ross
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 16th, 2005
Last updated Mar 1st, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033191994 NPPES
Ohio MEDICAID 2497463
Ohio Other 7030574
Ohio Other 000000329893

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