Provider Demographics
NPI:1376713974
Name:ARNO W WEISS JR, MD PC
Entity type:Organization
Organization Name:ARNO W WEISS JR, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:MS
Authorized Official - First Name:PENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-753-2061
Mailing Address - Street 1:800 COOPER AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-5394
Mailing Address - Country:US
Mailing Address - Phone:989-753-2061
Mailing Address - Fax:
Practice Address - Street 1:800 COOPER AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-5394
Practice Address - Country:US
Practice Address - Phone:989-753-2061
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010327862082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the HandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2105235Medicaid
MI0P55670Medicare PIN
MI2105235Medicaid