Individual
THOMAS WEAVER
Active
Individual
THOMAS WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
3174
OK
363AS0400X
Surgical Physician Assistant
Primary
PA.0007255
CO
Other
Enumeration date
04/01/2020
Last updated
12/15/2022
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