Individual
BARTLEY ANDERSON WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
861 OLD WINSTON RD STE 103, KERNERSVILLE, NC 27284-7141
(336) 802-2300
(336) 802-2301
Mailing address
100 KIMEL FOREST DR, WINSTON SALEM, NC 27103-6074
(336) 716-1331
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2024-01156
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2021
Last updated
08/01/2024
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