Individual
DR. MICHAEL JAMES WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
553 KINGSTOWN RD, WAKEFIELD, RI 02879-3600
(401) 304-9111
(401) 284-0625
Mailing address
553 KINGSTOWN RD, WAKEFIELD, RI 02879-3600
(401) 304-9111
(401) 284-0625
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5003
RI
208600000X
Surgery Physician
05003
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MW01082
—
RI
Enumeration date
05/02/2006
Last updated
08/28/2019
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