Individual
MICHAEL WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4401 WORNALL ROAD, KANSAS CITY, MO 64111
(816) 932-2047
Mailing address
901 E 104TH ST, KANSAS CITY, MO 64131-4517
(816) 502-8752
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
R8673
KS
208M00000X
Hospitalist Physician
R8673
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100123830B
—
KS
05
—
100123830F
—
KS
05
—
200969129
—
MO
01
—
80285136
BCBS
—
01
—
930072142
RAILROAD MEDICARE
—
Enumeration date
08/17/2006
Last updated
09/11/2020
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