Healthcare Provider Details

I. General information

NPI: 1336714963
Provider Name (Legal Business Name): MICHAEL DENNIS WEAVER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2021
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

IV. Provider business mailing address

200 HAWKINS DR DEPARTMENT OF INTERNAL MEDICINE
IOWA CITY IA
52242-1009
US

V. Phone/Fax

Practice location:
  • Phone: 319-356-1311
  • Fax: 319-356-8280
Mailing address:
  • Phone: 319-356-1311
  • Fax: 319-356-8280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberDO-55605
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number2023043514
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: