Individual
BRIAN SHANKLIN WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
814 KEMPSVILLE RD, SUITE 104, NORFOLK, VA 23502-4001
(757) 455-8887
Mailing address
927 EAST BLVD, CHARLOTTE, NC 28203-5203
(704) 377-5772
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
MT186418
PA
207LP2900X
Pain Medicine (Anesthesiology) Physician
0101245237
VA
208VP0000X
Pain Medicine Physician
0101245237
VA
208VP0014X
Interventional Pain Medicine Physician
Primary
0101245237
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5911825
—
NC
01
—
P00918125
RAILROAD MEDICARE
VA
Enumeration date
12/14/2006
Last updated
03/27/2015
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