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Individual

DR. KIBWE AKIN WEAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
601 JOHN ST, SUITE M-283, KALAMAZOO, MI 49007-5341
(269) 488-1524
(269) 488-1655
Mailing address
601 JOHN ST, BOX 42, KALAMAZOO, MI 49007-5341
(269) 488-1524
(269) 488-1655

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
001073
GA
208600000X
Surgery Physician
Primary
4301099598
MI
208600000X
Surgery Physician
T1019
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0203907382
BCBS
MI
05
1013180876
MI
Enumeration date
04/11/2008
Last updated
09/27/2018
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