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Individual

JONATHAN D. WEIMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
5325 APPIAN WAY, CHARLESTON, SC 29420-7234
(843) 552-0400
(843) 552-1618
Mailing address
201 SIGMA DR STE 100, SUMMERVILLE, SC 29486-7722
(843) 552-0400
(843) 552-1618

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2744
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2998PA
SC
Enumeration date
05/24/2017
Last updated
07/18/2017
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