# MARVIN V WEAVER IV

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1801112503
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | 207675 | LA | Yes |
| 2086S0129X | Vascular Surgery Physician | 269236 | NY | — |

## Other

- **Enumeration date:** 04/20/2010
- **Last updated:** 01/07/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2387405 | — | LA |