Individual
MR. K. MICHAEL WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R PH
Contact information
Practice address
7972 BAY DR, SAND POINT, MI 48755-9753
(989) 856-2657
Mailing address
7972 BAY DR, SAND POINT, MI 48755-9753
(989) 856-2657
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302019405
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5302019405
MICHIGAN BOARD OF PHARMACY
MI
Enumeration date
06/03/2008
Last updated
06/03/2008
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