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NPI Code Detail

MEDICARE: PAUL MICHAEL WEATHERS PA-C

MEDICARE: PAUL MICHAEL WEATHERS PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant100876NC

General Provider Information

NPI Number : 1871565523
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL MICHAEL WEATHERS PA-C
Provider Business Mailing Address
First Line : 7025 THERMAL RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28211-6173
Country : US
Telephone Number : 704-366-1636
Fax Number :
Provider Business Practice Location Address
First Line : 13845 CONLAN CIR
Second Line :
City : CHARLOTTE
State : NC
Zip : 28277-2705
Country : US
Telephone Number : 704-544-2092
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2006
Last Update Date : 07/08/2007

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Directions to “ PAUL MICHAEL WEATHERS PA-C” Practice Location

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