David R. Weaver

Debarred entity

Born 30 Nov 1954 (71 years old),United States. Named in 5 sanctions listings.

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Summary

License number: PROMISe#: 102666301

Sanctions and listings5

Effective
19 Jan 2023
Official designation
Pennsylvania Department of Human ServicesUS Delaware Medicaid Sanctioned ProvidersUnited States
Provider agreement will be terminated effective 60 days
medicaid.dhss.delaware.gov
Effective
19 Jan 2023
Official designation
New York State Office of the Medicaid Inspector GeneralUS New York State Medicaid ExclusionsUnited States
omig.ny.gov
Effective
19 Jan 2023
Official designation
Department of Human ServicesUS Pennsylvania Medicheck listUnited StatesPrecluded
pa.gov
Effective
19 Jan 2023
List of Excluded Individuals/Entities (LEIE)
Department of Health and Human Services Office of Inspector GeneralUS Health and Human Services Inspector General ExclusionsUnited States
1128a1
Programme US-HHS-OIGoig.hhs.gov oig.hhs.gov
Effective
6 Oct 2022; 6 Apr 2022; 4 Apr 2022; 18 Jan 2021
Official designation
Michigan Department of Health & Human ServicesUS Michigan Medicaid Sanctioned Provider ListUnited States
Summary Suspension Terminated Summary Suspension Summary Suspension
michigan.gov

Positions held1

Period not retained
PAIN MANAGEMENT (PHYSICIAN (MD, DO))

Identifiers2

Identifier	Number
ID number	OS014356
NPI number	1720067606

Other names4

Also known as4

David WeaverDavid R WeaverWEAVER DAVID RDAVID RUSSELL WEAVER

Addresses3

(WV), (WV)
P O BOX 1000, #34493-509, MORGANTOWN, WV 26507
Farmington Hills, MI

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