Provider Demographics
NPI:1063694644
Name:WEIGLER, GREGORY LEE (DO)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:LEE
Last Name:WEIGLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:6255 INKSTER ROAD SUITE 201
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48135
Mailing Address - Country:US
Mailing Address - Phone:734-425-7230
Mailing Address - Fax:734-425-7927
Practice Address - Street 1:6255 INKSTER RD STE 201
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:MI
Practice Address - Zip Code:48135-2538
Practice Address - Country:US
Practice Address - Phone:734-425-7230
Practice Address - Fax:734-425-7927
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2007-12-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5101015251208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology