Healthcare Provider Details

I. General information

NPI: 1316515521
Provider Name (Legal Business Name): CLIFFORD M WEEKES PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2021
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1328 PATTERSON ST
MONROE NC
28112-4348
US

IV. Provider business mailing address

1328 PATTERSON ST
MONROE NC
28112-4348
US

V. Phone/Fax

Practice location:
  • Phone: 704-694-6700
  • Fax:
Mailing address:
  • Phone: 704-694-6700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number0010-15588
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: