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General NPI Number Information
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NPI Number | 1538493028
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Entity Type | Individual
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Provider Name | MEGAN ELYSSE WEAVER PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/30/2009
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Last Update Date | 01/12/2017
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Provider Practice Location Address
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Address Line | 8775 NORWIN AVE
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City | NORTH HUNTINGDON
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State | PA
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Zip | 15642-2718
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Country | US
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Telephone | 855-765-7277
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Fax | 724-863-0046
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Provider Business Mailing Address
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Address Line | 520 JEFFERSON AVE SUITE 400
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City | JEANNETTE
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State | PA
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Zip | 15644-2538
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Country | US
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Telephone | 724-527-8060
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Fax | 724-522-4002
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MA054161
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License Number State | PA
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