Doctor Name: | QUINTON EDWARD WEIGNER |
NPI Number: | 1801873500 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA |
License Number: | 1070456 |
Business Practice Address: | 300 Tuskegee Blvd Dover Afb, DE - 199025300 |
Business Phone Number: | 3026772669 |
Business Fax Number: | |
Mailing Address: | 2002 Magnolia Ct, #2 DOVER |
State: | DE |
Postal Code: | 199017925 |
Phone Number: | 7192130999 |
Fax Number: | |
NPI Enumeration Date: | 12/23/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 1070456 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |