| Mitchell Ross Weaver, MD | |
|
2799 W Grand Blvd, Detroit, MI 48202-2608 | |
| (313) 916-3156 | |
| (313) 916-3023 |
| Full Name | Mitchell Ross Weaver |
|---|---|
| Gender | Male |
| Speciality | Vascular Surgery |
| Experience | 28 Years |
| Location | 2799 W Grand Blvd, Detroit, Michigan |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033191994 | NPI | - | NPPES |
| 2497463 | Medicaid | OH | |
| 7030574 | Other | AETNA PROVIDER ID# | |
| 000000329893 | Other | OH | ANTHEM BC/BS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2086S0129X | Surgery - Vascular Surgery | 35-084264 (Ohio) | Secondary |
| 2086S0129X | Surgery - Vascular Surgery | 4301069776 (Michigan) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Henry Ford Hospital | Detroit, MI | Hospital |
| Henry Ford West Bloomfield Hospital | West bloomfield, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Henry Ford Health System | 0547178311 | 2304 |
| Entity Name | Henry Ford Health System |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134144801 PECOS PAC ID: 0547178311 Enrollment ID: O20031105000139 |
| Entity Name | Henry Ford Macomb Hospital Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134265986 PECOS PAC ID: 7911808381 Enrollment ID: O20040119000142 |
| Mailing Address | Practice Location Address |
|---|---|
| Mitchell Ross Weaver, MD 2799 W Grand Blvd, Detroit, MI 48202-2608 Ph: (313) 916-3156 | Mitchell Ross Weaver, MD 2799 W Grand Blvd, Detroit, MI 48202-2608 Ph: (313) 916-3156 |
Kaitlyn Dobesh, MD Surgery Medicare: Medicare Enrolled Practice Location: 2799 W Grand Blvd, Detroit, MI 48202 Phone: 313-916-2600 | |
Dr. Bellal Ali Joseph, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 2799 W Grand Blvd, Detroit, MI 48202 Phone: 313-916-3056 Fax: 313-916-9920 | |
Charles Edward Lucas, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 4160 John R St, Suite 615, Detroit, MI 48201 Phone: 313-745-4195 Fax: 313-993-8669 | |
Christopher Paul Cassell, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 22101 Moross Rd, Detroit, MI 48236 Phone: 313-343-4000 | |
Alexander Marinica, Surgery Medicare: Accepting Medicare Assignments Practice Location: 6071 W Outer Dr Ste 121, Detroit, MI 48235 Phone: 313-966-3222 | |
Dr. Rachel Wobig, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 2799 W Grand Blvd, Detroit, MI 48202 Phone: 313-916-5071 Fax: 313-916-9920 |