Provider Demographics
NPI:1790739050
Name:WEEKS, STEVEN DOUGLASWEEKS (PA-C)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:DOUGLASWEEKS
Last Name:WEEKS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 S MAIN ST
Mailing Address - Street 2:PO BOX 245
Mailing Address - City:KEEDYSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21756-1346
Mailing Address - Country:US
Mailing Address - Phone:301-432-5714
Mailing Address - Fax:
Practice Address - Street 1:35 AIKENS CTR
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-5708
Practice Address - Country:US
Practice Address - Phone:304-264-2290
Practice Address - Fax:304-264-2295
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV01133363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant