Provider Demographics
NPI:1952346520
Name:WEEKE, PAUL C (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:C
Last Name:WEEKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1817 MILLHOUSE CT
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-5808
Mailing Address - Country:US
Mailing Address - Phone:336-834-8283
Mailing Address - Fax:
Practice Address - Street 1:800 N JUSTICE ST
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791
Practice Address - Country:US
Practice Address - Phone:828-696-1000
Practice Address - Fax:828-696-1314
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101040996207P00000X
NC29187207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNCQ522BOtherMEDICARE PTAN
VA010200458Medicaid
VA00W623S08Medicare ID - Type Unspecified
VA010200458Medicaid