Individual
DR. RICHARD WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2080 W ARLINGTON BLVD STE A, GREENVILLE, NC 27834-3770
(252) 689-6161
(252) 689-6164
Mailing address
2080 W. ARLINGTON BLVD, SUITE A, GREENVILLE, NC 27834
(252) 689-6161
(252) 689-6164
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
42555
CT
208VP0014X
Interventional Pain Medicine Physician
042555
CT
208VP0014X
Interventional Pain Medicine Physician
42555
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001425554
—
CT
01
—
040042555CT01
BLUE CROSS BLUE SHIELD
CT
01
—
042555
CONNECTICARE
CT
01
—
223514271
UNITED HEALTHCARE
CT
01
—
2900827006
CIGNA
CT
01
—
5764115
AETNA
CT
Enumeration date
06/07/2006
Last updated
07/19/2017
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