Individual
DR. TRAVIS WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1815 E IRELAND RD, SOUTH BEND, IN 46614-2845
(574) 647-1700
(574) 647-7572
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
(574) 647-2129
(915) 742-2748
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
0102204753
VA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
02007513A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300083607
—
IN
Enumeration date
04/09/2015
Last updated
12/11/2023
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