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Individual

DR. SCOTT S WEAVER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
2791 S QUEEN ST, DALLASTOWN, PA 17313-9540
(717) 741-4788
(717) 741-5945
Mailing address
2791 S QUEEN ST, DALLASTOWN, PA 17313-9540
(717) 741-4788
(717) 741-5945

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000112
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01491301
BLUE CROSS
PA
01
0165770001
DMERC REGION D
PA
01
410004079
RAIL ROAD MEDICARE
PA
01
66649
BLUE SHIELD
PA
Enumeration date
09/23/2005
Last updated
10/12/2010
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