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Individual

DR. LORRAINE E WEAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1122 PROFESSIONAL DR, GOSHEN, IN 46526-3819
(574) 533-0560
(574) 533-1716
Mailing address
PO BOX 834, GOSHEN, IN 46527-0834

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01060244A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200518070
IN
Enumeration date
06/16/2006
Last updated
05/03/2023
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