Individual
DR. DAVID WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
7300 N CANTON CENTER RD, EMERGENCY MEDICINE DEPARTMENT, CANTON, MI 48187-1579
(734) 454-8002
(734) 454-2733
Mailing address
29150 BUCKINGHAM ST, SUITE 6, LIVONIA, MI 48154-7502
(734) 207-9999
(734) 838-0052
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0102202236
VA
207P00000X
Emergency Medicine Physician
Primary
5101008321
MI
207P00000X
Emergency Medicine Physician
OS014356
PA
207R00000X
Internal Medicine Physician
5101008321
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11293324
CAQH
—
05
—
1720067606
—
MI
Enumeration date
01/10/2006
Last updated
09/22/2016
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