Individual
BRANDON MICHAEL WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
510 S 4TH ST STE 140, FULTON, NY 13069-2952
(315) 592-3930
(315) 592-3932
Mailing address
110 W 6TH ST, OSWEGO, NY 13126-2507
(315) 349-5511
(315) 349-5921
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
008798-1
NY
Other
Enumeration date
02/12/2007
Last updated
03/29/2023
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