Individual
DR. DONALD D. WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1612 31ST AVE, GULFPORT, MS 39501-2750
(228) 864-8454
(228) 865-1457
Mailing address
30 S. CLINTON ST., SUITE 7205, WALLA WALLA, WA 99362-2497
(509) 522-1358
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
14403
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00114891
—
MS
01
—
110136321
RAILROAD MEDICARE
MS
Enumeration date
08/22/2006
Last updated
07/08/2009
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