Individual
MR. JEFFREY LEE WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, MMS
Contact information
Practice address
725 W LOMBARD ST, SUITE 163 B, BALTIMORE, MD 21201-1009
(410) 706-2125
(410) 706-3243
Mailing address
PO BOX 64442, BALTIMORE, MD 21264-4442
(410) 706-2125
(410) 706-3243
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C03641
MD
Other
Enumeration date
06/09/2008
Last updated
07/15/2010
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