Individual
MICHAEL JOSEPH WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
300 MEDICAL PKWY STE 200, CHESAPEAKE, VA 23320-4985
(757) 625-4455
(757) 625-1829
Mailing address
300 MEDICAL PKWY STE 200, CHESAPEAKE, VA 23320-4985
(757) 625-4455
(757) 625-1829
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110001534
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58870P
SENTARA HEALTH PLAN
—
05
—
8944938
—
VA
01
—
P00025992
RAILROAD MEDICARE
VA
Enumeration date
07/20/2005
Last updated
02/04/2022
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