Individual
DR. SCOTT S WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
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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