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Individual

DR. MARK EDWIN WEAVER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
158 WETHERBY LN, WESTERVILLE, OH 43081-4957
(800) 917-9085
Mailing address
PO BOX 21930, COLUMBUS, OH 43221-0930
(800) 917-9085

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
35.050156
OH

Other

Enumeration date
11/04/2011
Last updated
11/04/2011
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