Provider Demographics
NPI:1871541656
Name:WEIDNER-CZAJA, HALINA T (MD)
Entity type:Individual
Prefix:DR
First Name:HALINA
Middle Name:T
Last Name:WEIDNER-CZAJA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:401 S BALLENGER HWY
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3638
Mailing Address - Country:US
Mailing Address - Phone:810-342-1000
Mailing Address - Fax:810-342-1590
Practice Address - Street 1:43900 GARFIELD RD
Practice Address - Street 2:STE. 205
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-1128
Practice Address - Country:US
Practice Address - Phone:586-263-9920
Practice Address - Fax:586-263-6831
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301056269208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1022821OtherHAN MHP
MI3035289Medicaid
MIF77747OtherHAP
MI4956916Medicaid