Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 125055289 | IL |
Y | 207YS0123X | Facial Plastic Surgeon | 072477 | GA |
NPI | 1417103557 |
---|---|
Provider Name | Dr. David Michael Weeks |
First Address | Marietta, GA 30060-1110 |
Second Address | Marietta, GA 30060 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2008 |
Last Update Date | 05/09/2018 |