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Individual

EDWARD WEAVER JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1205 FLORAL PKWY, WILMINGTON, NC 28403-6216
(910) 791-6086
(910) 392-8087
Mailing address
1205 FLORAL PKWY, WILMINGTON, NC 28403-6216
(910) 791-6086

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1234
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0250H
BCBS PROVIDER ID
NC
05
7909965
NC
Enumeration date
06/16/2005
Last updated
08/20/2007
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