Individual
MS. KIM PRICE WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
2135 NEW WALKERTOWN RD, WINSTON SALEM, NC 27101-3420
(336) 703-1516
Mailing address
2135 NEW WALKERTOWN RD, WINSTON SALEM, NC 27101-3420
(336) 703-1516
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0010-00098
NC
Other
Enumeration date
06/04/2012
Last updated
06/04/2012
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