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Individual
ANDREA R WEIGAND
Active
Individual
ANDREA R WEIGAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1161
NV
363A00000X
Physician Assistant
Primary
PA-2785
ID
363AM0700X
Medical Physician Assistant
5601005914
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1161
NV PA LICENSE #
NV
01
—
5601005914
STATE OF MICHIGAN
MI
Enumeration date
02/11/2009
Last updated
07/23/2024
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